At our office, we routinely screen patients using the Patient Health Questionnaire PHQ-9, a survey that asks you to rate how often you experience nine symptoms of depression. Some people wonder why we ask these personal questions about their thoughts and feelings. The PHQ-9 helps the doctor determine whether a patient is suffering from clinical depression and how severe the symptoms are. It also helps monitor the progress of patients who are already being treated for depression.
Depression can cause physical symptoms including unexplained headaches, backache, muscle aches and pains, fatigue, dizziness, chest pains, upset stomach, difficulty sleeping or an excessive desire to sleep, constipation, and a suppressed immune system. It is important for the doctor to determine whether undiagnosed depression might be responsible for some of your symptoms.
Depression is also associated with a number of illnesses, including flu, mononucleosis, thyroid deficiency, stroke, multiple sclerosis, cancer, head injuries, Parkinson’s disease, and heart disease. Approximately 31 percent of diabetics suffer from clinical depression. Depression is more than just the normal distress a person feels when faced with poor health or the loss of physical function. When it is diagnosed and treated, the patient often experiences fewer symptoms and recovers more quickly.
Depression is a treatable medical condition that causes persistent sadness and affects every aspect of your life. If left untreated, it can continue for months and recur in the future. The earlier depression is diagnosed and treated, the better the outcome. Depression has long-term effects on your health, and hurts your relationships with family members and friends. Many people turn to alcohol and drugs when they are depressed.
The causes contributing to depression include hereditary tendencies, exposure to traumatic events, physical illness, poor diet, chemical or hormonal imbalances, stress, abuse or bullying, grief, loss, difficulty adjusting to new situations, or a feeling that your life is out of control and you are inadequate to cope with the challenges you face.
Treatment for depression is typically a combination of medication, counseling or psychotherapy, and treatment of underlying medical conditions. Your doctor monitors your progress and can refer you to a specialist if the depression continues. Effective treatments include cognitive behavior therapy (CBT), which teaches you to recognize and restructure negative thinking patterns, and interpersonal therapy (IPT) which helps to resolve troubled relationships that may have caused depression.
Symptoms of depression include:
- Persistent sadness, anxiety, or feelings of emptiness
- Feelings of hopelessness, guilt, worthlessness, or helplessness
- Irritability and restlessness
- Loss of interest in activities or hobbies
- Fatigue and low energy
- Difficulty concentrating, remembering details, and making decisions
- Insomnia, early-morning wakefulness, or excessive sleeping
- Overeating or loss of appetite, accompanied by changes in weight
- Thoughts of suicide, suicide attempts
- Aches and pains, headaches, cramps, or stomach aches that do not respond to treatment
Men and women experience depression differently. Women are more likely to experience feelings of worthlessness, while men are more likely to experience fatigue, insomnia, loss of interest, and anger and irritability, as well as becoming abusive or engaging in reckless behavior.
Young people and the elderly are particularly susceptible to depression, yet it often goes undetected. Older people suffering from other illnesses may not recognize symptoms of depression because they think it is normal to feel lethargic, apathetic, and sad. In fact, depression is not a normal part of aging. Depression may be a side effect of a medication, of an illness such as heart disease or stroke, or of hardening blood vessels.
Adolescents naturally experience some ups and downs as part of growing up, but persistent bad moods and feelings of low self-worth are not normal. The symptoms of depression in teens may be different from adults, and may be misinterpreted as behavioral problems. These symptoms include fits of irritability and aggression, crying for no apparent reason, extreme sensitivity to criticism or rejection, a sudden drop in grades and loss of interest in school, risk-taking behavior such as unprotected sex and substance abuse, and addiction to the internet. A depressed teen may maintain one or two close friendships while cutting off from other social relationships. Adolescents who have a family history of depression may be more prone to depression themselves. Left untreated, adolescent depression can lead to the onset of mental illness later on.
About 2.5% of children in the U.S. suffer from depression. In addition to sadness and increased irritability, symptoms of depression in children include changes in sleep and eating habits, spending more time alone, becoming unusually clingy or dependent, and complaining of stomach aches or other pains. Listen to your child. It may be difficult for a depressed child to talk to you about his or her thoughts and feelings. Be careful not to be judgmental or offer unwanted advice. Try to understand what your child is saying.
Depression will not go away by itself. Do not take a wait-and-see attitude. Children and teens are dependent on their adult caregivers to seek out health care. If your child or teen exhibits symptoms of depression for more than two weeks, schedule an appointment with your primary physician and explain your concerns. The doctor will screen for depression and look for underlying physical causes such as mononucleosis or hepatitis. Children and teens often respond well to treatment. Early treatment is important so that your child can continue to grow emotionally and physically in a healthy way. Untreated depression can lead to more serious episodes later in life, and the accompanying social and behavioral problems can make everyday life difficult.
The most serious consequence of adolescent depression is suicide. In the U.S., suicide is the second leading cause of death for youth and young adults, following accidents. Don’t dismiss a teen who talks about being worthless or says things like, “Everyone would be happier if I wasn’t here.” Other danger signs are threats of suicide, giving away favorite possessions, writing goodbye letters, and using alcohol or drugs to try to sleep or forget their troubles. Seek help from a healthcare professional.
Do not leave a suicidal person unaccompanied. Call a local suicide hotline immediately, or call 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255).
Depression can be successfully treated. If you suspect that you or a loved one is suffering from depression, seek help right away.