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Healthy Living Guide
by Anne Berleant “It’s a snapshot of how you’re feeling,” said Janet Lewis, community coordinator of Bar Harbor-based Healthy Acadia, passing out a form called the PHQ-9 (Patient Health Questionnaire-9). Answering these 10 straightforward questions will help you and your doctor determine whether depression plays a role in your life. “Sometimes it’s hard to start a conversation with your doctor,” Lewis said. The PHQ-9 is an individual screening tool designed to jump-start a discussion with your doctor or nurse practitioner on your mental well-being. You can complete the form at home and give it to your doctor at your next visit. The PHQ-9 can be taken by any adult; it’s not designed for those with a chronic disease. However, depression rates among patients with chronic illness range as high as 50 percent, Lewis said, in a vicious cycle where the depression aggravates the chronic illness. Among the general patient population (defined as people who have primary care physicians), those suffering depression peaks at 25 percent nationally. Good mental health contributes to living successfully with chronic illnesses like diabetes, heart disease, arthritis and multiple sclerosis, Lewis said. But depression often lives silently alongside chronic illness, with the physical symptoms and ramifications of that illness overshadowing mental health concerns. Lewis described chronic illness as a condition that lasts a long time and generally cannot be cured. “Chronic” is defined as lasting longer than three months. The value of the PHQ-9, Lewis explained, is that individuals can give the form to their doctor or nurse practitioner as a medically accepted screening tool. “In theory, someone can use this screen confidentially and…[his or her] doctor will be able to read and understand the scores,” Lewis said. “Primary care practices are starting to assess generally people’s mental health status,” Lewis said, as part of taking a patient’s entire health picture into account. In fact, she said, just answering the first two questions on the PHQ-9 can help identify “trends” in a person’s emotional well-being. These are: “How often over the last two weeks have you (1) had little interest or pleasure in doing things, and (2) been feeling down, depressed, or hopeless?” You complete the questionnaire by selecting “not at all,” “several days,” “more than half the days,” or “nearly all the days,” then the score is tallied from the first nine questions and can be interpreted by your doctor or nurse practitioner. However, you can easily add your score and read the results on the back of the questionnaire, although the instructions do specify “for doctor or healthcare professional use only.” While it can be hard to say the words “down,” “depressed,” or “hopeless” to your doctor, a patient has to specify those words for a primary care physician to diagnose depression. “People will do anything not to be pigeonholed,” Lewis said. By using a written, self-reporting approach, “the PQH-9 avoids the problem.” The PHQ-9 can be found online through Googling; from the long list of results, choose one that’s marked “PDF” if you just want to download the form, or contact Lewis at Healthy Acadia at 288-5331 or janet@healthyacadia.org. |
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