Wednesday, 29 November 2023

What to expect when your brain wants to kill you excerpt from chapter: Major Depressive Disorder - A PRIMER

 


Major Depressive Disorder is a severe mental illness which affects 7.6% of the population or nearly 2.5 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.


The percentage of Canadians 15 years and over who have had a major depressive episode in the past year has increased substantially over the last decade.  In 2012, 4.7% met the diagnostic criteria, compared to 7.6% in 2022.  Young women between the ages of 18-24 were most likely to report suffering from MDD (18.4%).  Among males in my age group (45 to 64), the prevalence is 5.4%.



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 primary symptoms are a 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 is constantly fatigued by a barrage of destructive thoughts. I'm often exhausted by the noise in my head.


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. Don’t embellish your symptoms or dismiss them as inconsequential (as I did). 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 an effective course of treatment.

 

I was first diagnosed with the PHQ-9. Pfizer released this screening and monitoring questionnaire in 2010. It consists of 9 questions, which are designed to gain insight into a patient's thoughts and feelings. It asks, "How often have you been bothered by the following over the past 2 weeks?" It covers 9 different symptoms of depression ranging from appetite to sleep patterns, from self-esteem to suicide ideation. Each answer is assigned a score. The total of all nine questions identifies the level of depression the patient is experiencing.


The first time I filled out this questionnaire, I was identified as severely depressed. Even today, with my depression somewhat managed, I score between moderate and moderately severe. 


 PHQ-9


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