MAJOR DEPRESSIVE DISORDER – A PRIMER
Major
Depressive Disorder is a serious mental illness which affects 4.7% of
the population or nearly 1.5 million Canadians (Statistics Canada).
It is a deadly disease which kills, by way of suicide, between 2% to
7% of those suffering from the illness.
Symptoms
of MDD
I
remember when I was first diagnosed. It was my first visit to a mood
disorder clinic and two separate psychiatrists interviewed me with a
full battery of questions. Independently, they both arrived at the
same conclusion: MDD. At the time I thought they had got it wrong
because I didn't feel sad. How could I be depressed let alone
“majorly depressed” if I wasn't sad? As they reviewed the
reasoning behind their conclusions however, it became clear I checked
off nearly all the boxes.
The
most common symptoms of MDD are :
- Depressed mood
- Feelings of guilt, worthlessness, helplessness or hopelessness
- Loss of interest or pleasure in usually-enjoyed activities
- Change in weight or appetite
- Sleep disturbances
- Decreased energy or fatigue (without significant physical exertion)
- Thoughts of death
- Poor concentration or difficulty making decisions
My
symptoms included an constant and overwhelming urge to plan and
complete suicide, a feeling of being useless and worthless, being
overburdened with stress and anxiety, being paranoid of the future,
feeling hopeless in the present, and regretting my past. My mind was
constantly fatigued by a barrage of destructive thoughts. I was
exhausted by the noise in my head. I thought it was my life I
wanted to stop but actually it was just the disease.
The
diagnosis of a mental health disease is unique from other medical
conditions. Since there are no objective tests that can be given, it
relies on the skill of the psychiatrist or family doctor and the
honesty of the patient. Do not embellish your symptoms or dismiss
them (as I did) as inconsequential The only way you will get
better is by building trust and sharing how you really feel. By
listening to your words and observing your behaviour, a doctor can
provide a better course of treatment. In retrospect I'm amazed at
how long I went before seeking help. I was certain at the time that I
could tough it out.. I now realize there was no way I could have
continued for much longer.
Waiting for a diagnosis
What
I found the most frustrating part of the diagnosis was the time it
took to get to see a psychiatrist. It took eight months and that
was actually fast tracked. According to the Mood Disorders Society
of Canada more than a third of patients wait more than 12 months to
see a psychiatrist to get their diagnosis.
Like
many others, I had managed my symptoms on my own for many years. In
the spring of 2016 though, my suicide ideation become too strong. I
knew I needed help. My family doctor was my first contact and she
immediately put me on a waiting list for a mood disorder clinic. It
was the best thing she ever did for me. At the time though I
remember how devastated I was when I heard how long I would have to
wait. It had taken a great deal of courage on my part to reach out
for help. I hardly ever went to the doctor for anything and when I
actually asked for help I was told it would be a year or more before
I got specialized care.
At
the time I was angry and scared. In hind sight though I now advise
people in similar situations to be patient, be strong and stay safe.
I worked with my family doctor on preliminary strategies such as
diet, exercise and simple anti-depressant medication. Don't
discount the impact of diet and exercise. Studies have shown that
exercise is as effect if not more so than some medications .It took
me a while to accept this fact but there is no doubt that physical
activity effects my mood even if it is just walking the dog once or
twice a day..
While
you're waiting, keep a daily journal of your moods and activities.
See if you can identify any triggers. Are there any activities or
foods that make you feel better? What makes you feel worse? For me,
whenever I'm feeling down I gorge myself on bread and buns, a full on
carb binge. Afterwards I always feel sick, stuffed and guilty. My
mood is always worse than it was before I ate. Now that I recognized
this connection I try to made sure I do not have bread and buns in
the house. And if I do, I remind myself of the “evidence” I have
discovered, connecting carbs to my deepening depression. On some
occasions I'm actually able to stop myself mid-binge. On others, I
draw comfort from the fact that my mood is not me. Rather it is the
eight dinner roll I just scarfed down.
Another
trigger of mine is certain songs that I hear on the radio. These
songs are so familiar that by the time the chorus is reached, my mind
is already locked into a distinct path of melancholy and
hopelessness. Although I like the songs, I know on some days when I'm
particularly susceptible, I have to change the station or turn off
the radio altogether. Similarly, I have a few playlists on my phone
that I have to avoid . The songs are all time favourites so I do not
want to delete them but at the same time I recognize the danger to
myself. One day I will be able to enjoy them again, but until then I
have to keep myself safe. Music is powerful. It not only sinks my
mood, but lifts it as well. I have a playlist of songs that I know
will always encourage me on. I recommend you compile such a playlist
for yourself.
Keep
in mind that there is no real “cure” for MDD. Rather, it is a
matter of finding the best way to manage your symptoms. Ideally you
want to find the optimum balance between medications, behavioural
therapies and lifestyle changes. Recovery can be a long road but it
is definitely one worth taking.
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