Have you ever felt that something’s not quite right? Perhaps someone’s even suggested that you might need depression treatment only for you to think but I don’t need to know how to stop being depressed because I’m just working too hard.
How we think about our physical symptoms of depression, our feelings about ourselves and whether we are willing to acknowledge that something might be wrong seems to matter when it comes be getting an accurate diagnosis of depression.
A research project in England surveyed a family doctors practice including a total of 305 patients. The patients were assessed for anxiety and depression. They were given a series of set questions to answer. The answers they gave revealed that people explain (and understand) their problems in different ways. There were 3 types of answers given, these were:-
1. I don’t need to know how to stop being depressed: Normalising your problems
Normalising (where you might say, I am not depressed I am just working too hard that’s why I’m tired and fed up) Mostly younger people and men go for this explanation (or attribution to use the technical term).
2. I don’t need to know how to stop being depressed: Psychologising your problems
Psychologising: This is where you give a psychological explanation for your problems, (where you might say I am not coping very well right now at work and this is making me very negative and I’m feeling upset and irritable).
3. I don’t need to know how to stop being depressed: Seeing physical problems in place of psychology
Somatizizing: Where you mainly recognize physical symptoms and think there is actually something physically wrong with you (where you might say I am having headaches an upset tummy and I feel there is something wrong with my body.
I don’t need to know how to stop being depressed: What the research shows
So there are broadly three different ways you can describe your symptoms of depression. Of course the way you describe how you feel is in keeping with the way you would generally describe and understand problems. The reason this is interesting is that how you interpret your symptoms and how you talk to your doctor about them plays a big part in what kind of treatment you may get.
In the study we are describing, if you actually had diagnosable depression but described your symptoms to the doctor in a normalising way you have only a 15% chance of being diagnosed with depression and therefore getting the right treatment. If you described your symptoms in a psychologising way, you have a better chance of an accurate diagnosis, a 38% chance in fact. Those who used somatizizing language seemed to get what they wanted most of the time, perhaps because doctors felt more confident in treating physical problems. Whether this helped with their depression is a different matter.
I don’t need to know how to stop being depressed: Who says what, and why?
Men tend to use the normalizing strategy and women the psychologising strategy. Men typically externalise their psychological problems projecting them onto physical symptoms or onto their workplace, or circumstances that they are not directly responsible for. Women tend to internalise their psychological problems blaming themselves and feeling responsible for many things that they actually have little or no control over. Neither of these ways of thinking about your psychological problems is accurate, although of course it feels accurate at the time. Importantly, the inaccurate appraisal in both of the modes described above is thought to be a significant factor in the development and maintenance of depression.
I don’t need to know how to stop being depressed: How you talk to your doctor
You can also see that the way you think about your own problems and the way that you talk about them to your doctor can have an important impact on the kind of treatment you receive, if any.
Blues Begone trial data
In trials of Blues Begone in the NHS we have seen that people with mild depression are the least commonly represented whereas those with moderate and severe levels of depression are about equally represented. This may represent two aspects of the problem of recognizing depression at the doctor’s surgery.
Doctors are pretty poor at recognising depression
First doctors are pretty poor at recognising depression anyway. And second, the way the patient understands and describes their symptoms leads the doctor down a particular path of investigation. Therefore a normalising explanation will suggest one course of action, such as take some time off, whereas a psychologising explanation may suggest some psycho-therapeutic input and a somatizizing one may suggest further medical tests, which will be irrelevant to the goal of treating depression and feeling better.
The good news
The good news is that in our research we have found one overwhelming fact. Irrespective of the way the problem is described, as long as a patient uses Blues Begone it does not matter what severity level they start with. They will get relief and even recovery from depression and anxiety. This really does illustrate that no matter the starting point there is always the opportunity to make changes in your life. Given the right tools and the willingness to work at it good mood is only a course of Blues Begone away.
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