Depressive Disorders

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Depression is the most common psych condition I’ve come across during my time at the Veterans Affairs hospital. It permeates all age groups and has etiologies ranging from the loss of a family member to uncertainty about the future; in spite of this tremendous variability, two things seem to always be mentioned by patients which I’d like to remember.

First, I’ve had at least three patients say, word-for-word, “Doc… I just want to feel normal again.” These patients understand that they are below their “normal” baseline, and most of the time, they’re proactively clinging to whatever happiness they can get. They are making genuine efforts to find new activities or social circles which can rekindle the feelings they used to have, but sometimes they are unaware of why they lost their previous mood in the first place.

Second, when exploring suicidal ideations in patients, a couple have mentioned something along the lines of: “I want to die… for a little while.” They, quite literally, wish they could escape what they’re going through for a temporary period – and that’s the keyword: temporary. They understand the permanent nature of death and are unwilling to give up life completely, but the notion of “dying for a little while” intrigued me when I first heard it put into words.

Just as a closing remark, most of the patients I’ve seen with major depression have come to terms with their situation. They understand what triggered their depressive spiral and how they are going to try to get themselves out. Don’t be the pretentious interviewer who claims to “know what they’re going through.” You don’t. Most patients will understand that you’re saying that with good intentions, but why take the risk? Know your role as the interviewer and put the patient’s situation first.

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