Depression and Over-Diagnosis
Depression, along with other mental illnesses like ADD, has been in the media spotlight for some time. According to the World Health Organization, more than 300 million people worldwide suffer from depression, although some experts consider many of these diagnoses to be somewhat inflated. Allen Frances MD states that over-diagnosis of mental illness is making normality an ‘endangered species’, and threatens to increase the already alarming percentage of the population diagnosed as having a mental illness. So, with diagnostic inflation in mind, how can an individual presenting symptoms of depression know for sure whether they are diagnosable, or are simply facing the inevitable challenges of everyday life?
The Dangers of Self-Diagnosis
The internet can be a wonderful place. After all, it did bring you The Short Advice… There are a plethora of helpful resources online that offer support for various conditions, and can assist in making a diagnosis for mental illness. Whilst finding advice online isn’t totally unadvisable, it’s generally a good idea to confer with an expert before concluding that you have a medical condition. As stated above, over-diagnosis is currently considered an ‘epidemic’ by some medical professionals, and self-diagnosis has been highlighted as a contributing factor. So lets say you’ve done some online research, and decide to pay a visit to a psychiatrist. They tell you that, based on your symptoms and behaviours, you likely have depression. Let’s not forget now, that over-diagnosis by medical professionals has also been cited as a contributing factor to the epidemic… So who do we trust? Well, that’s a difficult question, and unfortunately there is no answer. Although, if you do agree that over-diagnosis is real, then anybody diagnosed should not rule out the possibility that perhaps their diagnosis is a stretch.
Depression vs Ordinary Life
So perhaps you are exhibiting some common symptoms of depression. It can be difficult not to be caught up in the hype of psychiatric fads. Yes, it is a mental illness. But, with the over-diagnosis of depression, it could also be considered a fad. Sometimes, trusting a diagnosis as widely-accepted and de-stigmatised as depression, is an easy way to explain, label and justify one’s suffering. Of course, de-stigmitisation is largely viewed as a positive outcome for patients. But it might also encourage others to buy into what is already an epidemic of over-diagnosis. So before you choose to medicate, take the time to engage in some critical self-reflection – at least make the pharmaceutical companies sweat a little… Lets start with 5 simple questions:
- Can you identify what exactly is causing you to feel depressed? i.e. Work pressures, bereavement, relationship woes, uncertainty about the future.
- When did you begin to feel depressed? (This might help to answer question 1)
- What (if any) changes were present in your life when these feelings began?
- What changes has your mood/current mental state caused in your life?
- Have you taken any steps to improve your situation? What are they?
Making Sense of Our Emotions
Hopefully you’ve been able to pinpoint some of the events in your life that have caused you to feel depressed. In this case, we are using the word ‘depressed’ as a temporary emotional state, rather than an illness. If we allow these issues to go unaddressed, what should be a temporary feeling of depression could turn into something far-less temporary. When we don’t properly deal with our emotions, and allow ourselves to fall into a ‘rut’, we get a snow-ball effect of poor decisions. These decisions only contribute to an elongated period of feeling depressed. And so, the hole gets deeper. A more effective management plan would be to address our emotions as they arise. Consider why you are suddenly feeling depressed. Is it an abstract concept, like fear of the unknown? Or perhaps something more concrete, like a fight with a loved one? Understand when you feel this way, and note other times you have felt the same.
Management Strategies for Building Resilience
Whatever the reason for your negative emotions, you need to develop strategies to counter this. It’s all part of ‘earning happiness‘, and developing resilience. If we immediately succumb to the challenges that are posed by ordinary life, and choose first to seek a diagnosis, it is almost as though we are ducking responsibility for our own emotions. So, the first and most important step is to:
1. Take accountability for your situation, and the improvement thereof.
Now you can start taking positive action to combat your negative emotions. It’s normal to feel depressed from time to time. We can’t always be happy. But falling too deep into self-pity is a trap that almost everyone can relate to. So feel sad, and pay heed to the negative experience. Understand the cause, and consider how you can minimise the effect of this should it happen again. This is a necessary process that helps us better manage our emotions the next time round. But, after you’ve focused on yourself, and improving your situation, the next step is to remind yourself how valuable you are. The best way to pull yourself out from under the blanket of self-pity is to:
2. Do something meaningful for somebody else.
Perhaps a family member, or friend, or maybe even a stranger. Helping others can be a humbling experience, that takes our mind away from our own problems. It is of mutual benefit for both the person helping, and the person in need of assistance. You might even be able to relate to some of the challenges that others are facing, and find that those challenges are indeed a part of ordinary life. Through helping others, you might also be helping yourself to find solutions to your own problems. Our third and final step for today’s article is an important one, which focuses on resilience:
3. Embrace the challenge.
Nothing worth doing is ever going to be easy. Accept the reality that you will not immediately find your happiness again overnight. You will have ups and downs, but the quest for happiness presents amazing opportunities to explore new avenues towards achieving a better balance. Your experiences, both positive and negative will continue to shape you, and your response to such experiences will define you. If you have experienced immense sadness, then moments of euphoric happiness await if you choose to work towards them.
Diagnosing clinical depression is difficult. There is no blood test or scan that can give conclusive evidence. Whilst there are many legitimate cases, there are also illegitimate ones. If you are experiencing symptoms, you should consider engaging in professional consultation (counsellor, psychologist, psychiatrist, GP). However, never waive the responsibility that you have over your own wellbeing. If you have been diagnosed, it may be worth seeking multiple opinions, or simply engaging in a management plan (developed by yourself and/or a professional), rather than medicating. The choice to medicate/accept diagnosis must be your own.
As always, thanks for reading and we’d love to hear what you think in the comments section below.