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High depression.



"...too much sadness hath congealed your blood, and melancholy is the nurse of frenzy."

-- William Shakespeare (1564-1616), English playwright and poet,

"The Taming of the Shrew"(1596)Act 2, Scene 2.

It's been more than a year since celebrity chef Anthony Bourdain hanged himself. This spectacular act of self-extinction still shocks us because practically no one saw it coming. As a rule, successful people who kill themselves bother us no end. Having reached the pinnacle, we'd think suicide would be the last thing on an alpha male (or female) mind. And yet there is such a thing as chronic depression, or its vicious variant, PDD (Persistent Depressive Disorder).

Dysthymia. This is another term for PDD and defines it as a type of depression that lasts for at least two years - so long that the person no longer remembers when it started.

PDD Symptoms are:

Prolonged low, dark mood.

Poor appetite or overeating.

Difficulty sleeping or oversleeping.

Low self-esteem.

Low energy.

Chronic fatigue.

Feelings of hopelessness.

What's in a Label? For some reason, most people can deal better facing this form of depression by calling it by what it is popularly known now as -- HFD or High Functioning Depression. There's a danger of trivializing the illness, but it does create an image of some high achiever who works hard, delivers the goods, and is then praised by society.Yet behind the facade is a depressed man (or woman) in a wretched life. In the 19th Chicago Orthopedic Symposium last year, Dr. Pamela Wible presented her study on 33 orthopedic surgeons who committed suicide for various reasons (#1 reason: professional ["medical errors, retirement, sexual harassment -and repercussions like loss of hospital privileges -- fraud, the system, bullying, stress & isolation, wrong career, and grief after sudden death of orthopedic partner]). Medical errors can make an orthopedic surgeon kill himself. Dr. Wible writes: "Perfectionism leading to self-loathing for even minor surgical errors, self-doubt after bad outcomes on knee replacements with pending hospital review, and one case involving an at-fault malpractice suit."

Risk Factors. PDD begins early, even in childhood and is chronic. Increasing the risk are the following: having a 1st degree relative with major depression, traumatic life events such as loss of a loved one or extreme financial distress, negative personality traits like pessimism and low self-esteem, and a history of personality disorders (

Treatment. It is imperative to see a mental health professional. Astute friends and relatives may want to coax their loved one to seek a consultation because one of the mainstays of treatment is psychotherapy and counseling. Antidepressants may be prescribed.

Prevention. Finally, the article on PDD, there are some strategies to "ward off" symptoms and these include: controlling stress, reaching out to family and friends, getting treatment "at the earliest sign of a problem" and getting long term maintenance medication. We have to be careful not to glamorize a condition that appears to be a choice but is not. It destroys lives and must be treated because it does not go away on its own.



Dr. Jose Pujalte Jr.
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Title Annotation:Opinions and Editorials
Publication:Manila Bulletin
Date:Jul 7, 2019
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