Awareness of mental health issues has become more prevalent over the last 10 years or so. Mental health struggles are also more socially accepted in society than they have ever been. My teenage daughter can rattle off a whole litany of mental health diagnoses and associated symptoms. In my high school years, I could barely talk about anxiety or depression, and it seemed to be associated with great shame or stigma. Flash forward, 25 years or so, and things have greatly changed, but there is still room to be made.
Today we will talk a little about depression, as it is one of the most common mental health diagnoses and struggles that we deal with in primary care. Approximately, 10% of all PCP visits have depression listed as a diagnosis. Women are more likely to be depressed than men and suicide has increased at an alarming pace with the 15-24-year-old age group by 87%, 2000-2020. In 2019 alone, 18% of adults reported that they had some symptoms of depression. The biggest fear of depression is suicide, in the same year, 45,000 suicides were reported.
So what is depression exactly? The National Institutes of Health (NIH) describes it as sad, depressed, anxious, empty, hopeless, worthless and helpless. These are very common symptoms of depression that you may be able to readily identify with depression. However, let’s discuss some of the more uncommon symptoms we see in primary care that can be attributed to other things but really are depression related. Fatigue, irritability, changes in appetite, sleeping too much, difficulty concentrating, headaches, cramps, and digestive issues. Sometimes, physical symptoms are a direct result of your body dealing with depressive feelings. The worst and most irreversible is suicide. It is contemplated by the young, old, rich, poor, sad, and sometimes the most “happy” looking people. Robin Williams was known for putting on a smiling, happy, face but he ultimately took his own life, which was a surprise to many people because of his perceived persona. Your PCP may have you take a quiz in the office called a PHQ-9 to determine your feelings in the last 2 weeks. This score will help them to decide if you meet depression criteria. The higher the score, the more likely you are to suffer from depression.
Treatment for depression can include many things. The most common treatments are meds and counseling. Although exercise and eating healthy have been shown to have benefits for mental health. In primary care medications are frequently prescribed as treatment. They can be very effective in treating depression, and as a provider I have had the opportunity to see big changes in people’s lives from medicines. I want to encourage you to do a few things if you try a medication. First, give it time to work, these medicines take several weeks to reach their maximum effect. Second, these medicines don’t work the same for everyone, it may take several attempts at different dosages, or medicines to get it right. Most of the time, we find the right one. Find a provider that will see you frequently enough, to “get it right”. And finally, if you feel suicidal on medications, CALL your provider! Counseling is often the first recommended treatment and really helps you to dig deep and deal with the roots of your depression, however, with the large numbers of depression it often takes a while to get to see a counselor or therapist. A lot of times, providers start medications in the meantime. This list is not inclusive, however most people find some help with either of these treatments.
HELP! If you feel as though you may be at the end of your line please know that help is literally A PHONE CALL AWAY!
IF YOU TEXT OR CALL 988, SOMEONE WILL HELP YOU-RIGHT NOW!
Below is the questionnaire used by professionals as a baseline for depression scoring. If you find yourself answering yes to these questions, please schedule an appointment with provider to discuss depression. It DOES NOT look the same to everyone, and it’s possible that the feelings you can’t quite put a finger on, maybe depression. There is help for you.
Sources: https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013. https://www.nimh.nih.gov/health/publications/depression many years of nursing experience.
Becoming Wellness Wise 