Depression Patient Advocate, Navigator or Health Advocate
The concept of patient advocacy in its current form was developed in 1950’s as the treatment of patients grew more and more technically complicated, as a means to make the voice of the patient more readily heard. In today’s world of constantly evolving medical techniques, treatments, and services, the average individual cannot be expected to be thoroughly acquainted with any and all this material. So it becomes the function of the depression patient advocate to perform a variety of services to ease the burden of the patient, and their family, as they learn to deal with every aspect of the disease.
The primary concern of the depression advocate is the support of the patient in all aspects of life with the disease, whether they be physical, emotional, or financial. An advocate can assist the patient in investigating available treatment options and educating the patient on the efficacy of each of them, be it pharmacological or surgical. By educating the patient, the advocate can be of great assistance in helping them make an informed decision about their course of action, and the possible side effects and outcomes. Support may also involve recommending counseling services for the patient, and their family members, to help them cope from day to day. Depression patient advocates may also be of assistance in helping the patient, and their caregivers, deal with any physical debilitation resulting from the disease, and its treatment.
Another aspect of depression patient advocacy is assistance in navigating the financial aspects of treating the disease. An advocate can act as a liaison between the patient and his or her insurance company, assuring that the patient receives any and all benefits to which they are entitled. When one is dealing with a serious disease, it is quite easy to lose track of other aspects of your life. An advocate can help to seek out sources of assistance which can ease the financial burden of the patient.
Education is also a major function of a health advocate. Both the patient, and their caregivers, are often in need of information about how the disease will affect their lives, both during its progression, and in its aftermath. Patients must be informed about how their condition will affect their mobility, the ability to care for themselves, and if they will be left with any permanent impairment to their lifestyle. Caregivers need to be instructed in mechanisms, or techniques they must use to cope with the patient’s daily care, such as injections, proper care of surgical dressings, etc.
The patient, above everything else, needs to know that there is someone in their corner. Someone who will help them find their way through the confusing, and sometimes daunting, world of modern medicine. Someone who will have their best interests in mind as they face challenges presented every day in their struggle to find, secure, and finance the best treatment available.
What is Depression?
Depression is a collective term referring to many mental disorders. Naturally, every person feels down and sad once in a while. For people with depression these feelings are prolonged and affect their family, social and even economic status. Most depressed people don’t accept that they are sick or that they need medical attention. With professional care, symptoms can be improved. Some types of depression are:
1. Psychotic depression. This group usually has hallucinations and delusions.
2. Postpartum depression (also called Puerperal psychosis). Seen in some women after child birth.
3. Seasonal affective disorder. Seen when exposure to light is reduced as in winter months.
4. Bipolar disorders. They have moods that swing to both extremes.
Symptoms vary in individuals and even in the same person depending on time, type of depression and the probable triggering factor. Some of the common symptoms are:
· Prolonged sadness.
· Pessimism and hopelessness.
· Guilty feelings for real or imagined wrongdoing.
· Irritability and restlessness.
· Chronic fatigue.
· Disturbed sleep patterns and quality.
· Anorexia and at times too much appetite.
· Suicidal thoughts or attempts.
· General psychosomatic symptoms like headache and indigestion.
Causes and Risk Factors
· Genetics play a significant role in depressive illnesses since the problem can run in families.
· Biological changes as seen in some women after giving birth.
· Certain environments can trigger symptoms.
· Psychological factors.
One factor is enough to trigger depression but in most cases a combination of these factors work together to send a susceptible person into depression. Other factors include:
· Trauma of losing a loved one.
· Difficulties in a family set-up.
· Stressful financial status.
· Women are more prone.
A thorough clinical assessment by a person knowledgeable in mental illness issues is enough to come up with an accurate diagnosis.
It is also important to rule out infective and systemic conditions that can trigger depression. Some of these tests include thyroid function tests, HIV test and any other which is relevant in the clinician’s opinion.
Establishing accompanying disorders is also important. A common disorder here is Post Traumatic Stress Disorder (PTSD) which is experienced by people who have witnessed or been part of horrifying events like war and devastating natural disasters.
Treatment involves dealing with any underlying problem. Removing the triggers help a lot. Sometimes it is not easy to establish a trigger. Psychologist and psychiatrists and physicians when they work together usually come up with good results. Occupational therapists are also an important part of the treatment team.
In most cases medications are necessary. They include:
· Antidepressants like those in the group of selective serotonin re-uptake inhibitors (SSRIs) and serotonin and norepinephrine re-uptake inhibitors (SNRIs).
· Tricyclics are older types of antidepressants which are losing out to newer drugs due to their side effects.
· Mono-amine oxidase inhibitors (MAOIs) are also from the old generation antidepressants but are very effective in some types of the depressive disorders. MAOIs must never be combined with SSRIs as their interaction can produce undesirable and serious side effects.
· Brain stimulation therapy – electro-convulsive therapy (ECT).
U.S. Statistics for Depression
According to the National Institute of Health (NIH) each year 6.7% of the adult population suffer from major depressive disorder.
Women are 70% more likely to suffer from depression.
The average age for the onset of the disease is 32 years.
About 3.3% of teens aged between 13 and 18 have suffered from serious depressive disorder.