Wednesday, February 22, 2012

My PSA on Depression

I'm going to preface my next post with this PSA on depression.
Doing evaluation after evaluation, I can recognize depression much quicker than I could in the past.  What's it mean to be clinically depressed? (Not 100% sure? Well, I'll educate you.)

  • To have what's called a Major Depressive Episode, you need to have 5 or more of the following symptoms during the same 2-week period and represent a change from previous functioning, while one of those symptoms are either 1) depressed mood, or 2) loss of interest or pleasure:
  1. Depressed mood most of the day, nearly every day, either indicated by a subjective report (for example, feeling sad or empty) or observation made by others (for example, appears tearful). In children and adolescents, this can be manifested by an irritable mood.
  2. Markedly diminished interested or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
  3. Significant weight loss when not dieting, or weight gain (for example, a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.  Note: In children, a failure to make expected weight gains could fall in this category.
  4. Insomnia or hypersomnia nearly every day. {Or, what we like to call "difficulty sleeping" or "difficulty staying awake"}
  5. Psychomotor agitation or retardation nearly every day, observable by others, not merely subjective feelings of restlessness or being slowed down.
  6. Fatigue or loss of energy nearly every day.
  7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
  8. Diminished ability to think or concentrate, or indecisiveness, nearly every day, either by a subjective account or as observed by others.
  9. Recurrent thoughts of death (not just fear of dying), recurrent thoughts of suicide without a specific plan, or a suicide attempt or a specific plan for committing suicide. 
  • These symptoms can't meet criteria for a Mixed Episode {Google it if you want}, and these symptoms have to cause "clinically significant distress or impairment in social, occupational or other important areas of functioning."  These symptoms also can't be due to effects of a substance (a drug, alcohol, or medication) or due to a general medical condition (hyperthyroidism, for example).  These symptoms also can't be better accounted for by Bereavement. 
  • Also, having a Major Depressive Episode can mean used in Mood Disorders, Major Depressive Disorder, or a Bipolar Disorder. So don't assume one over the other! Get a professional diagnosis.
  • Lastly, just because you don't meet the criteria (typically meaning you are experiencing 5 out of the 9, or one of the top two) doesn't mean you don't have a problem.  You can be diagnosed with what's called Depressive Disorder NOS ("Not Otherwise Specified"), or Mood Disorder NOS.
  • And let me throw in here that medication can help, as well as therapy, but the most beneficial treatment course includes both medication(s) and outpatient therapy (what I do!).
Think you're depressed? Get an evaluation! Whether you have private insurance, Medicaid (or whatever state-funded insurance you have), or no insurance, you can get mental health evaluations- sometimes for super cheap, sometimes for free... it just depends.   Whatever county you live in should be a part of a what's called an LME. Google your county's LME (for example, if you Google "Lincoln County LME," you'll find our LME, "Pathways" and their website) to contact them for an appointment with someone who takes your insurance, or takes clients without insurance. 

I've seen counselors in the past, and it's really helped. I am ABSOLUTELY horrible at taking medications, so I won't say I've been successful at that. And I will be the first, and not the last to say, that just because you are depressed DOES NOT mean something is wrong with you!! It's not healthy to stay depressed for long, and that's why there's professionals out there willing and ready to help you help yourself

I had a client tell me this week, "85% of your circumstances come from your attitude and your actions."  That might be a tough pill to swallow, but it's pretty deep, and not necessarily statistically accurate, but you get his point.  It's isn't always about what you're going through in life, but how you view your circumstances and what you do with them. 

Stay tuned for a personal part two...

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