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In this article of our monthly “Empowering the Citizen Patient” series, Dr. Mindy Smith, retired family physician and active member of the Kootenay Boundary Patient Advisory Committee, shares her expertise, tips and resources for supporting people who are affected by depression and/or anxiety. Join us as we continue our journey to empower both patients and those who care for them.

Mental health is a hot topic these days — from television, radio, to social media and kitchen table conversations. This surge in awareness is partly due to the opioid epidemic, the many crises our world faces, and of course, the COVID-19 pandemic. Mental health encompasses our emotions, feelings of connection to others, past trauma, our thoughts about ourselves and our ability to manage life’s ups and downs. Our mental health affects how we think, feel and act.

Depression and anxiety are nothing to be ashamed of and are treatable.

One of the ways we can learn more about ourselves is by considering these questions:

• In the past month, have I felt down or depressed or hopeless? 
• Have I been bothered by little interest or pleasure in doing things? 

If the answers are yes, you may be suffering from depression. 

• Am I a worrier? 
• Do I find it difficult to control worry once it starts? 

If yes, you may be suffering from anxiety.

Where to find more information about mood disorders

A tool that family practitioners use to assess depression is the Patient Health Questionnaire (PHQ-9). Similarly, for anxiety, one tool that can help identify an anxiety disorder is the Generalized Anxiety Disorder-7. See the kbpacc.ca website and HealthLink BC (https://www.healthlinkbc.ca/health-topics) for information and links to education about mood disorders and mental health.

Professional support is available to help treat mood disorders. The main treatments include counseling and prescription medication. Most guidelines recommend starting with counseling. Types of therapy that are effective for mood disorders include psychotherapy, cognitive behavioral therapy (CBT), and behavioral activation therapy.

You can find local counseling help online at KB FETCH, including the Healing our Spirits: Aboriginal Mental Health and Substance Use Program; on the Interior Health website; or through the BC government website. For some Indigenous persons, your benefits plan covers counseling from a qualified mental health provider, travel assistance if needed, and support services for indigenous persons affected by Indian Day School or Residential School survivors, family members and others affected by missing and murdered Indigenous girls and women in Canada (visit https://fnha.ca or call 1-855-550-5454 or contact an aboriginal health coordinator for help: https://coinations.net/referral-form-for-aboriginal-health-coordinator/).

What other help is available?

In severe cases of depression and anxiety, family practitioners often prescribe antidepressants. Different antidepressants work similarly well, so make sure to talk about side effects to find the best one for you. It’s important to note that sometimes the first medicine doesn’t always work; up to 50% of people might need to try a different one if there’s no improvement after 1-2 months. Also worth noting is that in studies of over-the-counter drugs, they have not been shown to consistently help with mood disorders.

For anyone experiencing severe symptoms including hallucinations (thoughts of seeing, feeling, smelling or hearing something that isn’t there), or delusions (a false belief about something despite strong evidence that it is not true), or suicidal thoughts, immediate help is available 24/7 by calling 1-800-SUICIDE (1-800-784-2433), KUU-US Aboriginal crisis line: 1-800-588-8717 (24 hours), or 310-6789 (24 hours) or go to your nearest emergency department.

This article only provides a small glimpse into the growing science about mental health, specifically highlighting mood disorders such as depression and anxiety. Stigma and discrimination are real issues for people living with mood disorder and mental health challenges, but know that you are not alone, and remember that these challenges are treatable, so please reach out for help.

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 Table 1. Tools for Screening for Depression or Anxiety

Table 2. Support Materials and References for Mental Health

Table 3. Specific to Depression

Table 4. Specific to Anxiety