PHQ - 9 overestimates prevalence of depression

More and more primary care medical practices are using the PHQ-9 depression screening tool and sometimes the abbreviated version. I've had it administered to me on my primary care medical visits along with my weight, blood pressure, and pulse.

A new study finds that these depression screenings over estimate the prevalence of depression. A symptom check list screening is not the same as a structured clinical interview for depression (SCID).

The most common misdiagnosis I find in my clinical practice is the depression for grief. Often I find that people who screened positive for depression in their doctor's office are actually experienced what is sometimes called "disenfranchised grief." Disenfranchised grief is sorrow and mourning triggered by a signficant loss that is not socially recognized, acknowledged, and therefore not supported with consolation and solace. Often I find that these patients have been started on an antidepressant medication which not treatment of choice for grief.

There is no substitute for good mental health care by a trained clinician.

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During school closure teens getting more sleep but it needs to be on a regular schedule

During the pandemic with school closure teens are getting more sleep which is a good thing because it makes them more communicative, family friendly, less moody while at home. It is important though to stick to regular sleep schedule. Staying up all night playing video games and messaging with friends is not conducive to a regular sleep schedule which is necessary to reduce inflamation and enhance physical and mental health.

I hear in my psychotherapy sessions about teen's symptoms of anxiety, depression, and irritability. I ask about their sleep. Almost always the answer is that it is disturbed and irregular in some way. This leads to an interesting observation. Is it the anxiety and the depression interfering with the sleep or the lack of sleep contributing to the symptoms? Which comes first the chicken or the egg? However you answer the question, improving the sleep cycle goes a long way in enhancing the feeling of well being.


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Need stress relief? Commune with nature.

The ego's need to be right is more powerful than the fear of death

Question

I wonder if we reopen and things get worse will those protesters admit they were wrong. Conservatives are very reality denying, even in the face of evidence. But the reality of the pandemic is very harsh, but is it harsh enough to break through their denial mechanism?

Jim

Answer

They'd rather die first than admit they were wrong.

Remember the Vietnam Era when they said, "Better dead that red."

These folks have to die off which social Darwinism predicts will happen. Let them swarm and infect each other, but you and yours stay home and the hell away from them.

People are more than willing to die for a cause as long as they don't have to lose face and admit they're wrong. The ego is a deadly thing.

I don't say these things lightly. I have seen it clinically with people who kill themselves and kill others and then themselves. Freud is accused of calling it a death wish but that is an oversimplification. It is the tremendous need to be right which is more powerful than death.

What is the purpose of your life?

This idea that people benefit from a sense of purpose is not only especially true for children but for people over 60 until their death as well. What is your purpose in life?

 

Feel Better Book For Little Tears

Do 12 Step Programs Really Work?

Do 12 Step programs really work?

From So Alcoholics Anonymous Is "Proven" to Work After All? Not So Fast by Stanton Peele on Filter on 03/08/20. For more click here.