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Depression


Depression is a sadly prevalent mood disorder, with over 18 million affected[1]. It is important to be able to recognize the symptoms as they appear in you or someone close to you, before drastic measures are required. Depression is defined as a persistent, unmoving mood of sadness or emptiness that lasts for a significant period. This often manifests with persistent thoughts of worthlessness and hopelessness, and can lead to suicidal thoughts. It is notably not just a ‘bad mood’ and cannot be simply willed away or ‘gotten over’.

To be diagnosed, one must strongly experience (they disrupt normal day-to-day functioning) 5 of the following symptoms for most of two weeks.

Per the Diagnostic and Statistical Manual of Mental Disorders (DSM 5)[2], these symptoms are:

Depressed mood for most of the day, every day, for a significant period. These moods could be characterized by sadness, hopelessness, or emptiness
Markedly diminished interest or pleasure in pleasure in all or almost all activities most of the day nearly every day. (things that used to be fun or entertaining are no longer so. Something fun or exciting before doesn’t produce the same response.)
Significant weight loss or gain without seeking either.
Inability to sleep or significantly oversleeping regularly.
Psychomotor agitation or retardation nearly every day. (Extreme restlessness and fidgeting, or slowing of physical activity or speech)
Regular and persistent fatigue or loss of energy. Being tired all of the time.
Regular feelings of worthless or excessive and inappropriate feeling of guilt. Feeling like everything is your fault, like you corrupt everything you touch.
Persistent difficulty or inability to think or concentrate.
Recurrent thoughts of death, or thoughts of suicide – either vaguely or with a specific plan.

Again, these symptoms must be persistent and severe enough to disrupt day-to-day functioning before a clinical diagnosis can be made. You’ll notice that many of the symptoms can go in either direction – as in the oversleeping or lack of sleep. The important bit is the persistent change from normal pattern to an extreme.

If you notice that you or someone close to you is exhibiting symptoms such as these, it is extremely important to talk to someone. The earlier these symptoms are caught, and the sooner treatment begins, the better the outcome.

If you or someone you know is planning to hurt themselves or commit suicide because of depression, call 911. DO NOT leave them alone, if you must leave the situation, have somebody stay with them. IF you can do so safely, take them to the nearest emergency room

Treatments for clinical depression vary, because the disorder differs significantly for every individual with it. There are medications available that help treat the symptoms. Counselling is also important in treatment. It focuses on re-orienting and equipping yourself with mental tools to deal with your brain ‘going rogue’.

With depression, hope is often key. Remember that it is treatable, that it doesn’t have to be terminal, and that it doesn’t define you, either.

As a primary care provider, we provide the first line of defense: we can put your worries to rest, answer any questions you might have, and put you into contact with the appropriate physicians faster than scheduling an appointment. [is this true?]

As always you can reach us via phone: (417) 624-4060, or schedule an appointment by visiting us during: [hours]

[1] (Kessler et al, 2005)

[2] (5th edition; DSM-5; American Psychiatric Association, 2013)

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Anxiety


Nearly 1 in 5 Americans have had an anxiety disorder[1], and a significant percentage of these were diagnosed as severe[2]. Anxiety disorders are a tragically common problem, and one that is important to understand and recognize. There are a family of anxiety disorders, including the various phobias and PTSD. We will focus today on Generalized Anxiety Disorder because almost 6.8 million adults in the US are affected by it[3].

Generalized Anxiety Disorder (GAD) is sometimes difficult to define, because it is, well, general. It is characterized by excessive and pervasive worry – worry over things that would seem insignificant, worry over things that others might expect as a matter of course, and excessive baseless worry about things that are even a little uncertain. Some people with GAD can function in society, albeit with much more stress, while others find themselves paralyzed with excessive and unfounded worry[4].

As with depression, the symptoms (the worry, anxiety, or physical effects) must be disruptive of normal life and functioning in important areas, and be consistently experienced for around 6 months for a clinical diagnosis of GAD. These symptoms include:

A persistent worry that is very difficult to control or manage.
Worry that is associated with three or more of the following:

Restlessness, being on edge, inability to relax
Being easily fatigued
Difficulty concentrating
Irritability
Difficulty getting sleep or restless, unsatisfying sleep.
Persistent muscle tension

Treatments for GAD are decided on an individual by individual basis, as it looks different in every person with it. It can also be tricky to diagnose due to how general the worry is, and the fact that it may also show up alongside other disorders. It is treatable, and there are a combination of counselling and medications available to mitigate or even eliminate the symptoms. Counselling often focuses on giving you the mental tools to discern valid worry and manage or eliminate the baseless anxiety.

If you or someone you know relates to these symptoms – please, talk to us, or a doctor you trust. The best progress can be made if it is caught before the worry becomes paralyzing. You don’t have to live with twice the stress of everyone else.

As a primary care provider, we provide the first line of defense: we can put your worries to rest, answer any questions you might have, and put you into contact with the appropriate physicians faster than scheduling an appointment. [is this true?]

As always you can reach us via phone: (417) 624-4060, or schedule an appointment by visiting us during: [hours]


[1] (Kessler, Chiu, Demler, Walters, 2005)

[2] (Kessler, Berglund, Demler, Jin, Walters, 2005)

[3] (Kessler et al. 2005)

[4] (American Psychiatric Association, 2013)