Are You Now, Or Have You Ever Been, Depressed?

So as a proud member of the underemployed, and as someone who just generally likes making a little extra cash, I often participate in surveys, studies, and focus groups. At one point I had a pretty regular gig doing vision studies through a research hospital and I felt like they were secretly training me for the CIA–one of the studies tapped into the massive funding available from Homeland Security by having participants look for weapons in luggage x-rays. (Conclusion: the less common weapons are in said x-rays, the less likely a screener is to notice a weapon when it’s there.)

Anyway, many of these require some kind of pre-screening to determine eligibility. For market research this often involves making sure you don’t work for an ad agency. Other studies are looking for very specific participants–say, dog owners who’ve bought several kinds of kibble over the past few months.

Aside from the standard demographic questions, many screening surveys ask about medical history.

And this is where I almost always lie.

I didn’t even realize I was doing it until today, but as I was filling out a screening survey (I didn’t qualify anyway) I noticed I didn’t check the box indicating I’ve ever been diagnosed with depression or any other mental illness.

I have. I’ve been diagnosed twice, in fact, by two different doctors–first for severe anxiety with mild depression, then for severe depression with mild anxiety. (I find these two diagnoses kind of amusing, but maybe that’s just a coping mechanism.) I’ve been on medication, twice. The second time around my depression probably led to some kind of eating disorder, although I don’t know that the symptoms fall neatly into the standard categories. I even ended up in my college infirmary for nearly a week, leading several people to suggest that maybe I should just take a leave of absence from school.

And yet, on form after form, I refuse to admit that I have a history of depression.

Some of this is purely practical–just as admitting to a history of illness can hurt your chances when it comes to applying for health insurance, admitting to any kind of chronic condition can disqualify you from any number of studies and surveys. And while I can understand the reasoning and don’t want to screw up anyone’s data, most of the time I justify the omission by telling myself that my inactive depression doesn’t really have any bearing on the kind of cat food I buy or whether or not I can track a green dot across a screen.

But it’s clearly not just about the practical. I also tend not to mention my psychological history to new doctors. (Again, maybe some of this is practical–does the physical therapist trying to strengthen my lower back need to know I’ve had anxiety attacks? But I get the feeling this isn’t information I would volunteer to a new primary care physician, either.) And that’s actually pretty dangerous. While not every medical symptom will necessarily have anything to do with my history of depression, many of them certainly could–in fact they could be signals of an impending relapse, just as seemingly benign symptoms mean more when you know someone has a history of heart trouble or cancer.

So why am I leaving out this extremely significant chunk of my past?

I’ve been trying to sort it out all day. This is the best answer I’ve come up with: I’m trying fiercely to not let depression be a part of my identity.

When I think back on the way I felt, the way I was when I was actively, painfully depressed, I have a hard time even recognizing that person as myself. At the same time that I see my psychological history as integral to the way I see the world now, I also seem to have this very real need to not see myself as depressed. I’m someone who was once depressed, not a person with depression.

Do other people experience this?

4 Responses to Are You Now, Or Have You Ever Been, Depressed?

  1. marcodante says:

    I agree with you about withholding certain information. While I believe in being open about having mental illness (otherwise it will forever be stigmatized) I don’t believe that everyone needs to have access to that information, especially persons or corporations who are in a position to discriminate. I went to a new dentist yesterday and on the back of the new patient form was a list of 50 or so diseases/illnesses that I was supposed to answer yes or no to. And I had to wonder, Why does my (hermetically sealed) dentist need to know if I have ever had a venereal disease or cancer or if I’ve been hospitalized in the past 2 years? I’ll tell him what medications I’m taking, but that’s where I draw the line and decide to answer NO to all the questions.
    Best to keep it on a need to know basis.

  2. pandanose says:

    Yeah, again, I can understand why a dentist might need to know about certain conditions if I need anesthesia or certain medications–I always tell dentists that I seem to need a lot of numbing agent, for instance–but just for a cleaning? No thanks.

  3. G says:

    In defense of dentists (and oral hygienists)…

    There are some good reasons they ask these questions. Your mouth is a part of your body, and stuff that affects your body affects your mouth (and vice versa). If your dentist knows you have diabetes or have been vomiting from morning sickness, they know to look for the effects on your teeth and maybe counsel you about potential oral problems. Dental work — even routine cleaning — can be dangerous for people with bleeding disorders or heart problems, but if your dentist knows then appropriate precautions can be used.

    The reason for the long screening checklist is that dentists don’t expect everyone to know the relationships between body and mouth health. People won’t necessarily volunteer that they had bacterial endocarditis recently because they don’t think it’s relevant to dental work. And yes, it is definitely important to tell them your medications and allergies — they don’t want to give you something that will cause a reaction or interact with your other meds.

    As for mental health. Mental illness is waaaaaay undertreated, which is partly because it is waaaaaay underdiagnosed, which is mainly because healthcare professionals don’t ask. There is pressure now to get primary care physicians, in particular, to ask about depression/mental health as part of their routine exams. So if your doctor is asking about your mental health history, one possible reason is that your doctor would like to help you.

    Obviously it’s up to you to decide if/when to disclose any part of your health history to anyone, and obviously there are lots of problems with various systems that can make that disclosure uncomfortable or problematic. I just wanted to point out that when we ask these questions, at least some of us healthcare people are trying to do the right thing (ie, help you, provide you with the highest standard of care).

  4. pandanose says:

    What are you, some kind of medical professional or something?

    [For those of you playing along at home, G is, in fact, a med student. A good one.]

    I shouldn’t pick on dentists–that was just the random example I pulled out of a hat.

    As for primary care folks, I would be thrilled to see them handling mental health in a straightforward (but sensitive) way. When I said I don’t think this is information I would volunteer, I was also realizing that I can’t remember the last time a doctor asked me about my mental health. Which is a little weird.

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