Dr. Zorba Paster: Shining a light on mental illness

Dear Doc: Thank you so much for your article in the paper on being proactive about discussing depression with your doctor. What a critical point. I also have been writing about this for years in whatever local publication will have me.

I am very passionate on this topic. I suffered from depression, and I suffered from the inability to act on my depression. My family suffered, too. Good job. Keep up the good work. – J.P.

Dear J.P.: Thanks for your kind comments. Depression is often a disease of shame. People are afraid to “admit” they have it and they need help. Counseling, medications and improving your home and work life only come after you “just say yes” and then seek help.

We need to move depression, and for that matter all mental-illness issues, out of the closet and into the open so we can shed light on those dark spaces so many people are in.

Dear Dr. Zorba: I fell two weeks ago – backward. I had no warning, just felt my head hitting the floor. I had a big goose egg but didn’t blackout or vomit, so I knew I was OK. But the next day, boy, oh boy, was I hurting. I went to my doctor, who took X-rays. Nothing broken, but the pain still hurts and hurts.

Last night, I had a Southern Comfort before dinner, but, of course, that’s something I can’t do every day. I’ve had three falls in the past four years, and all took time to get better.

Should I see a neurologist? I’m a very fit 83-year-old who doesn’t think she’s really that old. – M.B.

Dear M.B.: Congrats on being an 83-year-old who doesn’t think she’s an 83-year-old. You’re right to have that view but I’m afraid your bones and joints may not agree with you.

I’ve been watching my beautiful 1-year-old granddaughter walk, fall, walk and fall. Nothing breaks. She cries for a moment and then moves on. I wish I could say that, and I bet you wish you could say that, too.

Falls are a big risk factor in premature death in seniors. The “low-hanging fruit” you can reach to help prevent falls includes: night lights; getting rid of throw rugs or tacking them down so you don’t trip; and getting up slowly to let your body adjust, which is especially important if you’re on blood pressure medications or other pills that can lower your BP.

If you Google “fall prevention Mayo clinic” you’ll get more simple tips on preventing falls.

Now, do you need a neurologist?

Start with your primary care clinician. They often can do a screening that will help determine if you need a further examination. You need a face-to-face visit to find out what’s up.

Update: Finally, here’s some news on prostate-cancer screening. Recent research published in the Journal of the American Medical Association’s Surgery publication showed that since the U.S. Preventive Services Task Force recommended against prostate screening, prostate biopsies have dropped precipitously – by nearly 30 percent.

The Task Force gave prostate screening a flunking grade because it determined the practice didn’t save lives in the long run. While death from prostate cancer was reduced with screening, overall death rates from all causes lumped together were unchanged.

Whether to screen or not is an individual decision each man should make with his doctor. It is in cases like this where the art of medicine shines. Stay well.

Dr. Zorba Paster is a family physician, professor at University of Wisconsin School of Medicine and Public Health, and host of the public radio program “Zorba Paster on Your Health,” which airs at noon Wednesdays on 91.1 FM, and noon Sundays on 91.9 FM. His column appears twice a month in The Spokesman-Review. He can be reached at askzorba@doctorzorba.com. He loves mail.