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How and Why to Screen Yourself for Depression

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Depression is not just about “feeling blue.” It is a mental health disorder with roots in biology, psychology, and environmental factors, including neurobiochemical imbalance, hormonal changes, brain structure, inflammatory responses, and external factors like trauma, stress, etc. It is like trying to see light through a profoundly dense fog. Of course we want to be free of it, but its hold is so strong that it takes a lot to keep trying, and often, it forces us into submission.

Globally, depression impacts over 280 million people, according to the World Health Organization (WHO). That’s more than three-quarters of the U.S. population. It is 50% more common among women than among men. Over 10% of pregnant and postpartum women experience depression. The guy next door, the cheerful person at the coffee shop, the aunt who always has candy, the goofy person on the subway — anyone could be living in this condition.

“Am I just weak?”

“Will people think I’m just seeking attention?”

“What if I can’t afford the help I need?”

These whispers of doubt and fear are constant companions to those with depression. Left unchecked, depression isn’t just a soul-sapper. It’s a life disruptor. It wreaks havoc on health, relationships, and even one’s lifespan. And yet, despite its grip, the understanding and acknowledgment of depression remain elusive, making its impact all the more potent and destructive.

The Impact of Untreated Depression

It can be difficult to live with untreated depression. The weight of its impact touches not just the emotional corners of your heart, but often spills over to your physical well-being and social connections. It’s like a domino effect where one complication leads to another, making finding that sense of contentment and fulfillment in life even harder. Remember, it’s not just you feeling this; your loved ones might be deeply affected, and the ripple effect can touch even those beyond your immediate circle. Here’s how it could impact you. 

  • Deterioration of physical health: Chronic pain and fatigue, altered appetite leading to weight loss or gain, sleep issues like insomnia or hypersomnia, and increased susceptibility to chronic illnesses due to a weakened immune system.
  • Compromised emotional well-being: Persistent sadness, hopelessness, or emptiness, losing joy in favorite activities, difficulty in experiencing pleasure, and increased vulnerability to anxiety and other mood disorders.
  • Impaired cognitive functioning: Difficulty concentrating, making decisions, and remembering, reduced cognitive flexibility and problem-solving skills, and negative bias in thinking and perception of events.
  • Degradation of social relationships: Withdrawal from family and friends, strained relationships due to irritability and lack of communication, and isolation, leading to diminished support networks.
  • Impaired academic and occupational functioning: Decreased productivity and performance, increased absenteeism and presenteeism, and difficulty maintaining employment or achieving academic success.
  • Development of substance use disorders: Increased risk of alcohol and drug abuse, dependency on substances as a means of self-medication, and amplified health risks due to substance use.
  • Economic strain: Loss of employment leads to financial instability, increased health care costs due to comorbid health conditions, and reduced quality of life due to financial stressors.
  • Increased risk of suicide and self-harm: Elevated risk of suicidal thoughts, plans, and attempts, engagement in self-harming behaviors as a coping mechanism, and risk of death by suicide.
  • Escalation of coexisting conditions: Intensification of symptoms of existing mental health conditions, increased likelihood of developing additional psychiatric disorders, and amplified severity and complexity of co-occurring conditions.
  • Negative impact on loved ones: Emotional strain on family and friends, increased caregiving responsibilities and associated stress, and potential disruption in family dynamics and relationships.
  • Community and societal implications: Increased demand for health care and social services, increased risk of homelessness and incarceration among those with untreated mental illness, and reduced societal productivity and economic contribution due to impaired occupational functioning.

For those battling depression, swift action and the right care aren’t just beneficial — they’re vital. They can transform a life from despair to hope and strength. It all starts with recognizing the signs, screening, and seeking help.

Barriers to Seeking Help for Depression

Seeking help for depression is crucial, but many barriers stop us from accessing the necessary support and treatment. These barriers can be multifaceted, stemming from personal, societal, and systemic issues, and can significantly impact the effectiveness and availability of treatment.

Stigma and Discrimination:

  • Societal stigma: The fear of being judged or discriminated against can discourage people from seeking help.
  • Self-stigma: Internalizing negative beliefs about mental illness can lead to feelings of shame and inadequacy.

Lack of Awareness and Understanding:

  • Limited knowledge: Many people may not recognize the symptoms of depression or understand that it is a treatable condition.
  • Misinformation: Prevalent myths and misconceptions about depression can foster ignorance and bias.

Financial Constraints:

  • Cost of treatment: High costs associated with therapy, medication, and other treatments can be prohibitive.
  • Lack of insurance coverage: Inadequate or no insurance coverage for mental health services can limit access to treatment.

Inadequate Mental Health Resources:

  • Limited access to providers: A shortage of mental health professionals, especially in rural areas, can make accessing care difficult.
  • Long waiting times: The scarcity of mental health services can result in long waiting times for appointments, deterring people from seeking help.

Cultural Barriers:

  • Cultural stigma: In some cultures, mental health conditions may be stigmatized or misunderstood, making it challenging to seek help.
  • Cultural mismatch: A lack of culturally competent care can hinder effective communication and understanding between patients and providers.

Fear of Consequences:

  • Professional repercussions: Concerns about confidentiality breaches can make people worry about potential impacts on their employment or academic standing.
  • Relationship strain: Fear of straining relationships with family and friends can dissuade open discussion about mental health challenges.

Mistrust of the Health Care System:

  • Past negative experiences: Previous unsatisfactory encounters with mental health professionals can deter someone from seeking help in the future.
  • Perceived ineffectiveness: Doubts about the effectiveness of treatments can contribute to reluctance to seek professional help.

Logistical Obstacles:

  • Transportation issues: Lack of reliable transportation can be a barrier to attending appointments.
  • Time constraints: Balancing work, family, and other commitments can make it hard to allocate time for mental health care.

Gender norms and expectations:

  • Masculinity norms: Societal expectations about masculinity can make it difficult for men to express vulnerability and seek help.
  • Perceived weakness: Admitting to mental health challenges can be seen as a sign of weakness.

Health beliefs and attitudes:

  • Preference for self-reliance: A belief in managing problems independently can hinder help-seeking.
  • Doubts about severity: Underestimating the seriousness of one’s condition can delay the pursuit of help.

Comorbidity With Other Conditions:

  • Overlapping symptoms: Other mental or physical health conditions can complicate recognizing depression symptoms.
  • Priority of other conditions: People may prioritize managing other health conditions over addressing depression.

The variety of barriers to seeking help for depression necessitate concerted efforts from people with depression, communities, health care providers, and policymakers to create a supportive and accessible environment for mental health care. Enhancing awareness, reducing stigma, improving access, and providing culturally competent and affordable care are vital steps in ensuring that people with depression receive the help they need.

What Is Depression Screening

Depression screening is like a conversation starter, helping to break the ice around the often difficult topic of mental health. It’s a way to gently ask, “Are you feeling alright?” through thoughtful, standardized questions. These questions are designed to help you and your health care providers understand if you’re experiencing symptoms of depression and how severe those might be. It’s the first step. As Mighty contributor Jess W. said, “A formal diagnosis won’t make your depression any more or less real. It simply is. And whatever is for you — you’re not alone.

There are several tools available online for depression screening that can help you self-evaluate, along with the scoring guides to let you know what kind of help you may need.

1. PHQ-9 (Patient Health Questionnaire-9): This tool asks you nine simple questions about your mood, energy, and thoughts, aiming to understand how you’ve been feeling over the past two weeks. It’s widely used and recognized for its reliability and simplicity.

2. CES-D (Center for Epidemiologic Studies Depression Scale): Consider this a more in-depth conversation about your emotions and behaviors. It’s a 20-item questionnaire focusing on how frequently you’ve experienced symptoms associated with depression in the past week.

3. HADS (Hospital Anxiety and Depression Scale): Think of HADS as a kind, empathetic inquiry into both your anxious and depressive feelings, particularly designed for people dealing with physical health conditions.

4. Beck Depression Inventory (BDI): This one is like a more comprehensive heart-to-heart, exploring the depth of your thoughts, emotions, and behaviors related to depression, helping to pinpoint the intensity of your experience.

5. Zung Self-Rating Depression Scale: A considerate and structured self-evaluation, this scale helps you reflect on your mood, appetite, sleep, and other aspects of your daily life that might be affected by depression.

6. Geriatric Depression Scale (GDS): This is for older adults, helping them reflect on their feelings and mood. It’s specifically designed to screen for depression in older people, focusing on their unique challenges and experiences.

7. Children’s Depression Inventory (CDI): This helps in identifying depression in children, facilitating early intervention and support.

8. Hamilton Depression Rating Scale (HDRS): Consider the HDRS a meticulous and detail-oriented acquaintance, helping health care providers understand the severity and type of symptoms in those with depression.

9. Edinburgh Postnatal Depression Scale (EPDS): This tool acts as a supportive friend for new mothers, focusing on identifying postpartum depression and addressing the unique emotional challenges faced during this period.

10. Quick Inventory of Depressive Symptomatology (QIDS): This one is like a swift, attentive companion, helping to quickly assess severity of depressive symptoms and is useful for initial evaluations. 

11. Mood and Feelings Questionnaire (MFQ): This is like a considerate, empathetic guide for children and adolescents, helping to understand their emotional state and mood.

12. Columbia–Suicide Severity Rating Scale (C-SSRS): This scale specifically assesses suicidal ideation and behavior.

Depression screening tools are like open doors, welcoming anyone needing it and offering understanding and support. They are not about labeling but rather illuminating the way forward. It’s making that initial connection, letting someone know that they are seen and heard and that help is available. In a world where the shadows of mental health challenges can make you feel isolated, depression screening is a reminder that no one is alone in their journey.

Should You Get Screened if You Can’t Afford Follow-up Care

You decide to take a screening, but the “What’s next?” thought looms overhead. “Is knowing worth it if I can’t afford the subsequent steps?” It’s a real and poignant concern for many.

“Just having an answer — an understanding of WHY I’m feeling it, especially when there’s no specific reason — sometimes that helps me get through.” – Mighty contributor Jess W.

When resources are limited and finances are tight, even acknowledging that you may need help can be overwhelming. The fear of uncovering a need that can’t be met can feel debilitating, and it may seem easier to avoid confirmation of the condition.

Here’s why screening matters:

1. Knowledge Is Power: Understanding what you’re going through can be a source of empowerment, even if immediate professional help is out of reach. Knowing allows you to explore alternative support options and to better communicate your experiences and needs to loved ones.

2. Access to Immediate Support and Resources: Many screening tools and platforms can connect you to immediate support, such as crisis hotlines or peer support groups, which can offer a lifeline in difficult times.

3. Community and Online Support: Knowing your mental health status can help you seek out community resources, online forums, and support groups where shared experiences and advice can provide solace and guidance.

4. Exploration of Affordable Options: Knowing can motivate you to explore sliding-scale clinics, charitable organizations, or government programs that might offer affordable mental health services.

5. Self-Help Strategies and Lifestyle Changes: Understanding your condition can guide you to applicable self-help resources and encourage beneficial lifestyle modifications, such as regular exercise, a healthy diet, and stress management techniques.

6. Enhanced Self-Compassion: Recognizing your challenges can foster self-compassion and self-understanding, reducing self-blame and encouraging self-care.

If you’re contemplating getting screened because follow-up care seems unattainable, remember that understanding your mental state is a step forward. It’s a beacon of light, illuminating paths you might not have seen — paths of community, self-help, understanding, and, most importantly, hope. The journey may be challenging, but knowing allows you to start walking, and sometimes, the journey uncovers roads to healing we never realized were there.

“There are a lot of ways we can recognize (or ignore) depression symptoms in ourselves. And while the meds and the therapy tools and the self-care practices and AllTheThings can be helpful, sometimes what is most helpful for me is simply knowing that I am.” – Jess W.

Getty image by dmbaker

Originally published: October 5, 2023
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