Navigating anxiety and depression: A conversation with Dr. Benjamin Ramsey

Mental health challenges like anxiety and depression are something we all experience in one way or another. Yet, talking about them can still feel uncomfortable or even taboo for some. The truth is, you're not alone if you’ve felt, or are currently feeling, overwhelmed, anxious, or sad – these emotions are part of being human. But when they become persistent and start impacting your daily life, it's important to take them seriously. Benjamin Ramsey, MD, a psychiatrist at Appalachian Regional Behavioral Healthcare, helps us understand anxiety and depression and offers practical advice on how to manage them.

Anxiety: It’s normal to worry, but when does it become a problem?

We’ve all felt that nervous flutter in our stomachs before a big presentation or meeting. Dr. Ramsey points out that anxiety has its benefits. “Anxiety can motivate us,” he says. “For example, my fear of speeding makes me drive more carefully on my way to work, and that’s a good thing.” Anxiety can keep us alert and safe, but when it becomes constant and overwhelming, it can be a real problem.

Generalized Anxiety Disorder (GAD) is when this worry is excessive and hard to control for at least six months. “[GAD] can have several accompanying symptoms. One of the ones that I see the most is irritability. Often, people will avoid seeking help for mood symptoms until they are so miserable that they feel compelled to sacrifice time for an appointment or until others bring attention to the issue. Irritability is frequently the symptom that others notice.” This can manifest in snapping at a spouse or children, causing you to behave in ways you don’t want to. If anxiety starts affecting your relationships, work, or social life, it might be time to seek help.

Depression: Not just feeling sad

“What is happiness if you've never been sad?” Dr. Ramsey reflects. “The ups and downs in life bring us joy and perspective, but when sadness hangs on for weeks, it becomes something more.”

A major depressive episode is identified as lasting at least two weeks and includes symptoms like losing interest in things you used to enjoy, feeling hopeless, or having trouble getting out of bed. SIGECAPS is an acronym that can be used to remember other common symptoms of depression. Think of it as a checklist of how depression can show up in your life:
• S: Sleep changes – you might find yourself sleeping way too much, or on the flip side, you can’t seem to get a good night’s rest no matter what.
• I: Interest loss – things that used to bring you joy, like hobbies or spending time with friends, just don’t feel exciting anymore.
• G: Guilt – you feel like you're constantly beating yourself up or thinking you're not good enough, even when others don't see it that way.
• E: Energy loss – you’re so drained, even small tasks feel exhausting, like you're running on empty all the time.
• C: Concentration problems – it’s tough to focus, whether at work or just trying to make decisions at home.
• A: Appetite changes – maybe you're eating everything in sight or not feeling hungry at all, and it’s starting to show in your weight.
• P: Psychomotor agitation – you might feel restless, like you can’t sit still, or the opposite – moving slowly, almost like you’re in slow motion.
• S: Suicidal ideation – you might be feeling hopeless or having dark thoughts, and it can be hard to imagine things getting better.

“Depression is fairly prevalent, affecting about twelve percent of people. So, out of thirty people attending this health talk, approximately three or four might experience this in their lifetime,” Dr. Ramsey points out.

Overcoming the stigma of medication

If you're nervous about taking anxiety or depression medication, Dr. Ramsey encourages open conversations with your psychiatrist. “A good psychiatrist will ask why you're hesitant and offer treatment options that fit your concerns. It’s all about finding what works for you,” he explains. And if you’re worried about side effects, he reassures, "The goal is to find a medicine that doesn't cause you any side effects, and that's a realistic goal. The benefits of the medicine far outweigh the risk and possible side effects.”

Simple tips for managing anxiety and depression

While professional treatment is essential for managing more severe cases, there are simple steps we can all take to improve our mental health.

• Be mindful of your thoughts: Recognize when your thoughts aren’t serving you well and challenge them. Dr. Ramsey encourages people to ask themselves, “Are these thoughts helpful or accurate?” Feelings are not always fact.
• Take care of your body: Sleep, nutrition, and exercise all play a huge role in mental well-being. “Sleep problems are often tied to both anxiety and depression,” Dr. Ramsey says.
• Stay connected: Relationships and social support are key to mental health. "You might feel like withdrawing but staying connected to friends and family can make a huge difference," he advises.

The journey to better mental health isn’t about eliminating negative emotions – it’s about finding balance and being able to live a fulfilling life despite them. As Dr. Ramsey says, "The goal is not to have no emotion. It's to have a healthy balance."

If you’re struggling with anxiety or depression, remember, you’re not alone. Help is available whether through therapy, medication, or talking to someone you trust. By taking that first step to seek support, you’re already moving in the right direction toward feeling better. If you are interested in making an appointment with Dr. Ramsey, visit unchealthappalachian.org or call (828) 737-7888.

Watch Dr. Ramsey's Health Talk here