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Posts Tagged ‘depression’

Depression

As I have progressed in my OT training, both through classroom and fieldwork education, I have unexpectedly learned one reality of our profession: depression is all around.

This past fall semester, I did one of my Level I fieldworks in an inpatient mental health setting.  Through this experience, I realized that I really enjoyed working with people who were depressed.  I couldn’t explain it.  I just connected with them really well, and it felt so natural for me.  The problem was, though, that I couldn’t see myself working in a mental health setting.  But I really liked depression.

A weird thing to say, for sure.

Keeping this newfound interest in mind, I became more cognizant of places in which depression may present itself in Occupational Therapy.  And you know what I realized?

You don’t have to work in mental health in order to work with people who are depressed.

Depression is all around.  It’s part of the nature of what we do.

This realization hit me the hardest after sitting through nearly 30 student presentations on various medical conditions at the end of the fall semester.  During nearly every presentation, depression was mentioned as a common co-morbid condition.

Traumatic Brain Injury: depression.  AIDS: depression.  Alzheimer’s Disease, Fibromyalgia, Substance Abuse, Epilepsy, Multiple Sclerosis, Burns, Hip Replacement, Cystic Fibrosis, Binge Eating Disorder: depression.  And the list goes on.

When people lose their ability to function as much as they once did (even if only temporarily), or when people have a condition which causes them to believe that they will never lead a “normal” life, depression can easily set in (that’s not to say that it always does for every person, but…).

So here’s what I’m wondering.  Why do we pigeonhole “mental health” so that only people who want to work in “mental health” settings will be prepared to work with people who suffer from depression?  If depression can pop up anywhere, in any practice area outside of “mental health,” shouldn’t we all be prepared to respond therapeutically?  Our clients/patients don’t get to sweep their depression into just one corner of their life.  So why should we sweep our mental health training into just one corner of our profession?

Can Occupational Therapists address their patients’ depression even though their primary diagnosis may be that they had a stroke, or an amputation, or a Traumatic Brain Injury?

Our profession is supposed to be holistic in its view of people and its approach to their well-being.  Can our treatment reflect that when it comes to addressing depression (or other mental health issues such as PTSD, Anxiety Disorder, etc.)?

I realize that this is neither a simple question, nor will it lend itself to a simple answer, and there are many more layers that need to be talked through.

But I’ll end this post with one question: If you knew that you would likely treat people with depression no matter what type of Occupational Therapy you went into, how would that affect your preparation to enter the field, or your practice once you’ve already entered it?

I would appreciate any responses as I continue to think through all of this!

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When I was an undergraduate, I went through a period of being clinically depressed.  I met regularly with a Psychologist, and she helped me to understand what I was going through and how I could work on getting better.  Though it was a four-month period of my life that I hoped I would never have to re-live, it was also a time of great healing and self-discovery.  I almost cherish that time in my life because I was able to work through something that I thought would never end.  As a result, I have such empathy for people who experience depression or who are simply having a difficult time coping with the stressors of life.  It’s a difficult battle to fight.

This week, as I have been doing my Inpatient Psychiatric fieldwork, I have had many opportunities to reflect on that difficult period of my life.

Throughout the day we have several interactions with many different patients.  Typically, we first interact in a group with patients who are dealing with issues such as major depression or bipolar disorder or schizophrenia (to name a few).  Then we document what they did and what we saw.  Some of the documentation is narrative.  But most of it involves simply checking off a bunch of boxes.  Type of participation.  Type of affect.  Type of psychotic symptoms.  Amount of assistance given. After a few times of filling out these forms, I began to wonder.

What if I had gotten so depressed that I couldn’t function, and I had to come to a facility like this?  What if someone had filled out forms like these about me when I was depressed? I would really be reduced to a bunch of check boxes?  I would hate that!

Now I know what you may be thinking. They have the check boxes in order to standardize the forms and make them quicker to fill out, since healthcare staff always have so many forms to complete.

I understand that.

But it doesn’t change the fact that, if I was depressed and was staying at an Inpatient Psychiatric unit, and I was able to see the boxes that were checked off as a reflection of my group participation that day, it would make me feel weird.  I would feel like an animal in the zoo.  Or an experiment.

Maybe nobody has thought about psychiatric documentation like this before.  Maybe they have.  But I just found it very interesting how my personal experiences from the past were able to profoundly impact my visceral reaction to how OT’s document the performance of patients in psychiatric settings.

I suppose these are feelings that will shape my perception of many other things besides psychiatric documentation in the future.  But I at least hope that they will serve as a personal reminder that people are people – not boxes to be checked – no matter what they are going through.

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