Wednesday, 31 May 2017

What to Expect When You're Depressed - A PRIMER


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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