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Thursday, June 21, 2012
Diversity Toolbox

Report it right: Depression and traumatic brain injury

By Rebecca Tallent

On August 22, 2011, former University of Idaho psychology professor Ernesto Bustamante shot and killed his former student and lover Katy Benoit at her rental house.

After the shooting, Bustamante sequestered himself in a hotel room, a move that led to a stand-off with Moscow, Idaho, police and, ultimately, Bustamante’s suicide.

News stories focused on the mental health issues of both Bustamante and Benoit: Both had depression, and some psychotropic drugs were found in Bustamante’s hotel room.

When it comes to mental health and traumatic brain injuries, it’s likely many journalists just do not know how to deal with the issues. After all, the people “look” fine; they usually do not have visible signs of an illness or injury. But just as a spinal cord injury is a disability, so too is depression, states the Americans with Disabilities Act.

Martha Kitzrow, Ph.D, a licensed psychologist at the University of Idaho Testing and Counseling Center, said the National Institute for Mental Health reports 9.5 percent of the U.S. adult population is depressed or has a mood disorder (which includes major depressive disorder, dysthymic disorder and bipolar disorder), and 6.7 percent have been diagnosed with major depressive disorder.

“Depression can range from mild to moderate to severe,” Kitzrow said. “At moderate to severe levels it is likely to affect every aspect of daily functioning. Depression can impair cognitive, physical and social functioning and overall performance. However, even mild depression can have debilitating effects over time. It is costly in terms of human suffering, impaired performance and increase in missed days in a work or school setting, and increase in physical health problems.”

People can and do have mood fluctuations and may occasionally feel depressed, she said, noting that what distinguishes real depression is when the person’s mood does not return to normal within a short time. Diagnosis is normally made based on a minimum number of symptoms as well as the length and duration of the symptoms, a clinical assessment and history.

“I don’t think journalists can be expected to differentiate between the types of depression but can perhaps raise awareness about the different types of depression,” Kitzrow said.

“Only medical and mental health professionals have the training to accurately diagnose the types of depression. If a journalist is writing about a particular individual who has received a diagnosis of a depressive disorder, he/she could certainly use that information. If that information isn’t available then perhaps stating that the individual is being treated for an unspecified mood or depressive disorder would be appropriate.”

Another issue just as silent as depression is traumatic brain injury, which can include a stroke. Once again, the person usually looks “normal,” but his or her personality or ability to understand have changed. As with depression, traumatic brain injury can have a wide range of impact on a person, said Steve Saladin, Ph.D., a licensed psychologist and director of the UI Testing and Counseling Center.

“A TBI can be completely disabling (coma) to minimal impact (subtle deficits on testing that have little meaningful impact on daily functioning) and anywhere in between,” Saladin said. “It all depends on the severity of the trauma and the location of any damage.”

Saladin said common significant deficits from a mild traumatic brain injury (which is defined as a loss of consciousness/being disoriented for 30 minutes or less) include attention/concentration problems, memory impairment, slowed cognitive processing, depression, mood swings and being easily frustrated.

“For a severe TBI you are more likely to see motor deficits (difficulty walking, performing fine motor tasks, etc.), language deficits (problems understanding or producing coherent speech), clear lessoning of intellectual capabilities, personality changes and severe emotional difficulties,” he said. “In either case there can be significant headaches, especially when trying to concentrate. The person may look the same, but their lives are often altered dramatically.”

As with any disability, depression or a traumatic brain injury needs to be explained in a news or feature story secondary to the person, Saladin said.

“So, a person with a brain injury, not a brain-injured person. Avoid terms like ‘brain damaged,’” he said.

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