Just imagine, you are the doctor. All smart and fully trained, maybe not necessarily addicted to pain killers, but definitely sharp and always interested in solving health riddles. Hopefully wishing the patient well and feeling empathetic (even though House is probably not the most empathetic doctor of all times…).
So you have your patient number 1, waiting to be diagnosed and treated. Looking at her medical history it seems that the trouble started quite mildly.
First: A bit of fatigue and trouble with sleeping, loss of appetite.
Then: Unfortunately with time it only gets worse:
- loss of appetite turns into serious gastrointestinal problems
- trouble with sleeping into insomnia
- then the pain starts, first just noticeably, but later a full on back and joint pain, contact headache, in the end chest pain.
What do you do?
Maybe run some basic blood tests? All important microelements, red/white blood cells count, hormones.
What do you think the problem could be? Diabetes? Hyperthyroidism (overactive thyroid)? Anemia?
We get the first diagnosis: diabetes.
What do we think? It is not immediately life threatening but at the same time it is not an easy one you can get out of with a course of treatment: especially type one means insulin injections for the rest of her life. What I would like to ask you is to lift your eyes from the screen for maybe 30 seconds and, if you can, think how you feel about it. Do you feel sorry for the person? Do you think her condition is serious?
Hold on to this thought while the episode develops. After further analysis it turns out she does not have have diabetes. Our patient has depression. She has severe insomnia, has lost a lot of weight, has chronic pain and overall feels very ill.
Now can you try to go back to how you felt about the patient having diabetes? Has your perception of the seriousness of the situation changed?
I hope you have managed to hang in there and follow the story. What I am trying to show is that still too many of us think that depression is a mood swing from which you can just snap out by pulling it together. Too many of us still think it is a trivial health condition and a sign of weakness. Even if we do not do it consciously, very often somewhere at the back of our head we judge.
Depression is a real illness with real symptoms and need of treatment.
According to WHO report around 350 million of people in the world are affected by depression, around 4% of population. In the most developed parts of the world less than 50% get treatment, while in some countries it drops below 10%. Depression is the second cause of death in people between 15 and 29 due to suicide.
Depression, especially untreated, can give symptoms we studied at the beginning, plus very often leads to poorer functionality in the society and very low life satisfaction. The patient basically feels ill and is unhappy.
Depression is still a taboo, especially if affecting men. But when you analyse it from a biological perspective it involves the most complex unit of our body – brain. Why would we treat it with any less respect and concern than any other part of our body?
Causes of depression are endless from genetic to hormonal and some treatments that are effective for certain people will be completely useless for others. Though the most important step is to recognize it and take it seriously.
It is funny how we can be empathetic towards someone with a broken heart, but we do not take seriously a ‘broken’ brain. We still associate emotions with the muscle pumping blood in our chest, while biologically it all has its home in our brain. We own a very complex system of millions of chemicals working together in a very dynamic setup to keep us at balance. Maybe it is time we look first at ourselves and while we do a mental health check up of our body, we unsure we include the managing unit. And when looking at people around us, we should start seeing depression for what it is -a serious and terrible illness. And I promise, I am not being judgmental. I needed to learn as well.