IF SYMPTOMS PERSIST Dr. Jose Pujalte, Jr.

“Call no man happy until he is dead.” – Aeschylus (525 BCE-456 BCE, Greek playwright “Agamemnon” (458 BCE) L.928

It was classmate Martin D. Bautista who somehow got to scribble “Call no man happy until he is dead” at the back of my Grant’s Anatomy. We were, I suppose, in the throes of that most difficult of First Year Medicine subjects, and he was, I suppose, seeing all the sadness and depression around him. Now there’s a prescription period separating the mere “blues” and established clinical depression. Psychiatrists say it’s roughly two weeks. Almost steep. But time-wise aside, how do you know that you have crossed over from sadness to depression? Self Assessment. You can do this on-line (https://www.nhs.uk/conditions/stress-anxiety-depression/mood-self-assessment/). It is found in the UK’s National Health Service (NHS) website. It is not intended to replace a consultation with a professional. There are nine questions (from Spitzer, et al.) to ask yourself using the past two weeks as basis:

1. Have you found little pleasure or interest in doing things?
2. Have you found yourself feeling down, depressed, or hopeless?
3. Have you had trouble falling or staying asleep, or sleeping too much?
4. Have you been feeling tired or had little energy?
5. Have you had a poor appetite or been overeating?
6. Have you felt that you’re a failure or let yourself or your family down?
7. Have you had some trouble concentrating on things like reading the paper or watching TV?
8. Have you been moving or speaking slowly, or very fidgety, so that other people could notice?
9. Have you thought that you’d be better off dead or hurting yourself in some way?

There are four choices with point assignments. These are: NO, not at all (0 points), On some days (1 point), On more than half the days (2 points) and Nearly every day (3 points).  Add up the points. If you score between 0 and 10 points, you are unlikely to be depressed. From above 10 to 70 points, make an appointment – or call the number below. WHO Definition. “Depression is a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration.” While ideally we should refer to psychiatrists, there are other trained individuals such as psychologists, guidance counselors, and religious persons to approach. The first step is to reach out. The DOH recognizes the anxiety and depression brought by this pandemic. Call the National Mental Health Crisis Hotline @ 0917 899 8727 for help. 2020 World Happiness Report. Out of 155 countries in 2012 the Philippines ranked low at 103^rd.  Ranked again from 2017-2019 and presented in 2020, the country was No. 52 out of 156. The world’s happiest place isn’t Disneyland but Finland (the worst, Afghanistan). This was a “life evaluation score” factoring in health, education, freedom, social support, and corruption. The report also divided key determinants of happiness into “external” (income, work, community and governance, and values and religion) and “personal” (mental health, physical health, family experience, education, gender and age). Just a caveat though, a WEIRD (Western, Educated, Industrialized, Rich Democracies) study may have its biases. On a personal level though, if you’re not depressed, and just as happy whether its foie gras or fishballs, what’s to quibble on world happiness? And someday this pandemic will end. In the meantime, take charge of your mental health. Dr. Pujalte is an orthopedic surgeon. email [email protected]