WHAT IS THE PHQ-9?
The Patient Health Questionnaire-9 (PHQ-9) is a self-assessment module consisting of nine items used to determine if an individual is experiencing a depressive episode. In addition, based on the scores assigned to each of the nine items, this handy quiz can also provide a gauge for the severity of the depressive episode.
The PHQ-9 is based upon the diagnostic criteria for major depressive disorder in the DSM-5. The nine symptoms of depression are listed following a question, allowing you to complete the self-assessment tool. Using a scale of 0-3 to answer the question can provide an important barometer of whether you are struggling with major depressive disorder. A zero indicates the symptom is “not at all” present, and a 3 indicates the symptom present “nearly every day.” When 5 or more symptoms are answered in the affirmative, it may indicate the presence of depression. The PHQ-9 includes:
Over the last 2 weeks, how often have you been bothered by any of the following problems?
- Little interest or pleasure in doing things
- Feeling down, depressed, or hopeless
- Trouble falling or staying asleep, or sleeping too much
- Feeling tired or having little energy
- Poor appetite or overeating
- Feeling bad about yourself-or that you are a failure or have let yourself or your family down
- Trouble concentrating on things, such as reading the newspaper or watching television
- Moving or speaking so slowly that other people could have noticed. Or the opposite-being so fidgety or restless that you have been moving around a lot more than usual
- Thoughts that you would be better off dead, or of hurting yourself
Although major depressive disorder (MDD) affects 17.3 million U.S. adults per year, only a small percentage of people actually seek out treatment. A tool like the PHQ-9 can assist individuals in initiating the first steps toward getting treatment.
There are different types of depression, including:
- Major depressive disorder (MDD) is a serious mood disorder that can negatively impact all aspects of life, including work, family, and social spheres. Features persistent sadness, fatigue, sleep disturbance, change in eating habits, and suicidal thoughts.
- Perinatal depression is depression experienced during or following pregnancy, which features severe sadness, fatigue and anxiety
- Persistent depressive disorder refers to prolonged depression symptoms that vary in severity over a period of at least two years
- Psychotic depression has the symptoms of MDD with accompanying symptoms of hallucinations or delusions
- Seasonal affective disorder (SAD) is depression that aligns with the winter months when shortened days limit natural sunlight exposure
- Bipolar depression refers to the bipolar mood disorder when the individual is experiencing a depressive episode
WHAT CAUSES DEPRESSION?
The causes of depression are still not completely understood, although research and advanced imaging continues to offer clues into this complex mental health disorder. Presently, it is believed that five factors play a pivotal role in someone developing a depressive disorder. These include:
- Family history. There is a genetic feature to depression, as it is found that depression can run in families.
- Brain chemistry. Ongoing study into the role of neural activity and brain chemistry imbalances shows these to be factors in faulty mood regulation.
- Personality. Our individual temperaments or personalities may play a part in how we process and manage stressful life events.
- Stressful life events. Trauma, physical or sexual abuse, sudden loss of a loved one, divorce, a serious illness, or loss of a job can trigger a depressive disorder.
- Medical conditions. Certain health conditions may trigger a depressive disorder, such as cancer, heart disease, Parkinson’s disease, diabetes, lupus, stroke, dementia, or HIV. Some drugs used to manage health conditions can also cause the side effect of depression.
TREATMENT FOR DEPRESSION
Antidepressants. There are four types of antidepressants on the market, including SSRIs, SNRIs, tricyclic antidepressants, and MAOIs. With about 30 different antidepressants available, the mental health provider will aim to select the best medication for the patient’s specific diagnosis. There are various types of depressive disorders and each one may correspond to a particular type of antidepressant. Antidepressants take about 4 weeks to become effective in alleviating depression symptoms. It is common for a patient to trial 2 or 3 drugs before finding the right fit with the least side effects.
Psychotherapy. Psychotherapy is prescribed with antidepressants to provide an opportunity for the patient to work through any contributing emotional or psychological issues, such as grief and loss, a history of trauma or abuse, or relationship struggles. Cognitive behavioral therapy (CBT) is most effective in depression treatment, as this type of short-term therapy can help patients reshape their thought patterns toward more positive self-talk that leads to more constructive actions.
Holistic therapies. Complementary therapies can enhance the effects of traditional therapies by helping the individual achieve a more relaxed and peaceful state of mind. Holistic therapies are often added to the treatment plan, such as mindfulness meditation, yoga, acupuncture, massage, gardening therapy, equine therapy, and art therapy.
Diet. A healthy diet is important for improving brain health, which translates to mood. A diet rich in lean proteins like fish, turkey, and chicken, whole grains, nuts, and fresh fruits and vegetables will nourish the brain. Minimizing sugar, caffeine, and alcohol can enhance the nutritional effects and improve mood. Some herbal supplements have been shown to help alleviate the symptoms of depression. The most widely used for this purpose are St. John’s Wort and Sam-E. Be sure to ask your physician before using any herbal supplements that may interact with other medications.
Exercise. Ample clinical evidence demonstrates the connection between regular exercise and improved mood. Engaging in a weekly fitness regimen of 3-5 30-minute cardio workouts can alter the mood-regulating neurotransmitters, serotonin, norepinephrine, and dopamine, while also releasing the feel-good chemicals called endorphins.
CONTACT THE TREATMENT SPECIALIST
Why not use this free PHQ-9 assessment tool to begin the process of getting the help you need? The Treatment Specialist can provide helpful guidance about treatment options for overcoming the debilitating symptoms of depression. Call us today at 877-408-0734.