What Patients Should Know When Diagnosed With Depression

Yeah, so I guess the first question I want to ask you is, and I'm going to ask a bunch of questions and then you can take it where you want, I guess.

What is depression? What does it mean to have the diagnosis of depression? What's a diagnosis? And what is major depressive disorder? Kind of a big smattering, but yeah, I'll let you tackle that first.

yeah it's definitely an area big confusion i would say i think that there's this idea that depression there's this idea that depression is just one thing and it's certainly not in fact i would say that depression is probably the biggest umbrella term within psychiatry that applies to the most people today that or anxiety And depression is just a category of a feeling state or a set of syndromes that we recognize ways to treat.

Or that it's a down mood state where people are having some kind of trouble in their lives.

But it doesn't tell you actually all that much about what you should do about it or where it comes from.

And on top of that, that's still the case for major depressive disorder, the DSM category.

It doesn't actually tell us very much about what the problem is or how to fix it.

And that's probably why you see all of these problems out there in terms of the big scale studies on antidepressants.

Are they working or are they not? This is because we are labeling a lot of things that are probably different with the term depression.

And rightfully so, because each person with depression feels depressed.

But where does that come from and how does it work? That's another story.

Yeah, now, I feel like sometimes people think that there's people with major depressive disorder and then people without major depressive disorder.

And that there's, you know, if we were to scan your brain, we'd be able to find that people with major depressive disorder have some problem in this specific area.

Or what the pharmaceutical companies kind of told us, if we were to do the neurochemical analysis, that we would find that people with depression have lowered serotonin or have some sort of neurochemical difference completely different from the people who do have depression.

It's as if it's a thing that they absolutely have.

What would you say is the better way to think about it?

Well, I don't know if there is a better way to think about it because we'd have to all agree as a group.

But personally, what I like to think is depression, depression.

What we should be calling depression as a primary problem is people who have sadness, depression, or difficulty enjoying things.

In some way, that's pretty persistent.

At least two weeks in a row or just at least half of the time over a very long period of time, at least a couple of years.

that's something that you have and it comes with problems in your energy motivation sleep appetite all those kinds of things coming together that's what i see personally as more of a depressive syndrome are there people without those other symptoms that have a type of depression yes yes but they don't necessarily respond to the standard treatments

now What do you make of having the diagnosis? I guess, what does it even mean for a patient to be given a diagnosis? Does that mean that I'm forever going to have depression? Does that mean, how should I think about the fact that, you know, let's say I'm a patient who's been given the major depressive disorder diagnosis.

How should I think and relate to the diagnosis itself?

I think everyone should keep in mind that even for a more specific diagnosis that isn't an umbrella term like depression is, important to remember that diagnosis is for medical purposes it's just a very small way to capture a certain specific problem in your life it doesn't explain everything about you as a person and it still doesn't even explain your problem fully it's just a useful shorthand to zero in on what we can focus on together in the treatment so that's what a diagnosis is it's really for practical purposes it doesn't tell us too much beyond what we can expect from treatments and what we can expect in the future so because of that and because depression is this umbrella term some people will have a major depressive disorder essentially for the rest of their lives those are the kinds of people who do do well on some kind of medication or even multiple medications in the long term some people are only going to really have one major episode of depression And then some people are going to have minor depression here and there.