Rachel Carle

5/26/15
Klus
th
4 Hour
5

Depression: the Long Road of Misdiagnoses

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depression , that happiness is an

ongoing battle, and I wonder if it isnt one Ill have to fight for as long as I live. I
I start to think there really is no cure for

wonder if its worth it.

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--Elizabeth Wurtzel, author of Prozac Nation

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Depression

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Living Deep in the Well

105Screams echo through the narrow passage,

walls slowly closing in around me.

My voice is dry with desperation,
straining to cry out for help,
but mute.
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Fingers claw at divots in the stone walls,

Olympic efforts to no avail.
The few who make it out alive
are those who learn to persevere.
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Trial and error.

Up above, faint light is visible,
a computer screen in a darkened room.
120I trudge onward,
day after day,
grasping at all possible outlets.
I slip out of reach
125from the grip of family and friends
extending their arms
to full potential.
Attempt and fail.
130

With every new effort

overcome by frustration,
my grasp loosens and
desperation sets in
135like clouds of a slow moving storm.
Light is engulfed by darkness.
I lose hope.
Life lacks meaning
140as I fall
deeper and deeper
into the well.
(38 lines)

Depression

The Only Escape

Flickering in the summer night, the bud caught off and on in the slight breeze. John
pulled the lighter back out from his pocket. He cupped his hand and inhaled as he relit the joint.
145Puffs of smoke dissolved in layers with every exhale, temporarily blurring the stars above him.

Deep in thought, he went limp, body sinking into the rooftop. Eyes closed and rolling back into
his head, he couldnt think of anything hed rather be doing at this moment-- or any moment
really. Everything was numb. Nothing mattered.
John ignored the roof shingles scraping his arms and legs and the mosquitoes that
150swarmed every inch of exposed skin; swatting them away was far too much work. A million

other things raced through his mind. Life is so much better alone. He came up here every night as
an escape from everything else. Cant I just smoke pot for a living? Is that too much to ask for?
He took one last hit before putting out the ash. He twisted the bud of the paper into the graphite,
watching it sizzle on the slightly damp rooftop. The smoke twirled into the air in front of him as
155he bent down to take in one last inhale. He couldnt resist. Just as the smoke began to slow, he

flicked the joint down into the bushes beneath him. There had to be a collection down there-unless his mom found them like she had before. That was always a possibility, however, she
hadnt scolded him in awhile.
John slowly stood up. It was his usual routine to head inside once the thought of
160homework didnt phase him anymore. A huge glass of water called his name. His mouth felt like

he had just eaten a handful of cotton balls, and his eyes drooped with exhaustion. He knew by
this time that hed be getting a good nights sleep with no disruption. Crawling away from the
edge of the roof, John pulled his blanket along with. He grabbed the towel out from underneath

Depression

the cracked window--his way of concealing the distinct scent--and opened it up wide as he
165climbed through.

Frozen in the window casing, John watched as his mom sobbed into her hands. She was
lying on his bed, elbows buried in her lap, face covered with tears.
He collected himself enough to engage in a normal conversation. He was clueless as to
why she was in here in the first place. Mom? Jon climbed down from the window and walked
170over to her. Mom, is everything okay?

She looked up. Her face cringed with disappointment. The black makeup smeared
beneath her eyes, and deep wrinkles on her forehead made her appear twice her age. Can you
please explain this, John? She held up a clear bag of white powder.
How the hell did she find this? Its bad enough she knows I smoke pot. Now the cocaine.
175Mom...I...I can explain...I just...I dont know. Jon snatched the bag from her hand.

She fell into hysterical sobs. He didnt even have to explain for her to understand that her
son was a drug addict. Whats wrong with you? She suddenly stood and threw her hands into
the air. Ive put so much time and money into your treatments and you throw it all away with
with that. She swatted her finger toward the bag.
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You dont understand.

What is there not to understand, John? Her voice rose every time she spoke.
Its the only way I feel like I belong in this world. Its the only reason Im alive. He
looked down, nervous to see and hear what was next.
I dont know what to do with you anymore, she muttered as she began to pace the

185room, I cant keep paying these bills for counselors and antidepressants if youre going to act

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Depression

like this. She stopped walking and sat back down in the corner chair. I just want you to be
happy.
John walked over to his mom, dropped the plastic bag, and sat down on the arm of the
chair beside her. He bent down to hug her, wrapping his arms all the way around her. This is the
190only way that I can be happy.

(48 lines)

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Depression Diagnosis: Trial and Error

Walking into the bathroom, John refused to turn on the light--avoiding his image in the
mirror--and opened all the drawers in search of his pills. I cant be late school again. I wont be
able to graduate. Just as he was about to call it quits and get back in bed, he heard the pills rattle
as he opened one last drawer. Hands shaking, eyes watering, his relapsed body craved for his
200usual dosage of antidepressants. Two by two, he swallowed the pills that he hoped would give

him motivation to at least open up the blinds in his room today. I need to get dressed and go to
school. He swallowed the last two. Eight pills. Each oval shaped pill stood for something wrong
within him. Eight problemsas of now--that his psychiatrist had diagnosed him with (Out of the
Shadows).
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Depression has become a common illness that is often forgotten about because of its frequent
symptoms seen in all ages. While patients fall into this state of mind and try to receive help from
a physician, they often dont get the information and medicine that they need. Whether its an
antidepressant or a drug prescribed for a commonly mistaken illness, such as bipolar disorder,
diagnoses takes a long time of trial and error before finding the most effective pill (Kaye 1).

210Because so many symptoms pertain to a variety of illnesses, the diagnosis of depression should

not rely on the practice of counseling for diagnosis.

According to the Mayo Clinic, depression is defined as a mood or disorder that causes a
persistent feeling of sadness and loss of interest(Mayo Clinic 1). However, the definition of this
mental illness differs from each person that suffers from it. It may seem like an illness that has
215relevant conditions in every patient, but its much more complex than people see it to be.

Depression and other anxiety disorders are the most common illnesses in the US(ADAA). The
causes of depression can range from genetics to life tragedies (WedMD). Knowing that so many

Depression

people suffer from this mental illness in our world, psychiatrists have been working to find the
best possible way to successfully diagnose patients for helpful treatment (Szalavitz 3). A
220neuroscientist from TIME magazine explains her thoughts on depression, We do need

diagnosis: but both psychiatrists and patients alike should recognize that these labels are neither
immutable nor perfect (Szalavitz 3). The problem with our diagnoses today is that they are more
commonly inaccurate than not. It takes some people years to finally receive the right medication
or treatment available for them (Out of the Shadows). Again, not all depressions are the same; it
225depends on the person and how they respond to symptoms. With that said, people need to

understand that there is better treatment out there for the specialization of depression.
Using the old-fashioned way, counseling can led to being diagnosed with multiple mental
illnesses because psychiatrists are unsure of what is wrong. Through the interviews used in
counseling, the little time patients pay for is not nearly enough for a proper diagnosis. While
230counseling is good for getting to know the patient and have a deeper understanding as a doctor of

what goes on in someones life, it is no accurate mean of diagnosing. This method uses
symptoms to determine treatment. The problem is that the wrong diagnosis leads to wrong
medication, therefore leading to a hopeless patient (Szalavitz 1). Szalavitz explains the confusion
in his article, Which one should be treated? Or do they all require interventions? And what if the
235therapies conflict with each other? (Szalavitz 1). In many situations, psychiatrists are unsure as

to increase the dosage of an antidepressant or try another form of medication. The time it takes
for counseling heightens the risk of suicide as the depression worsens with unsure diagnoses
(Kaye 1). Professionals shouldnt be confused-- especially since counseling is a very long
process that takes time and money from the patient.

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Counseling has lead to many false interpretations to what specific disorder someone may have.
Patients who are labeled incorrectly seem to fall into a setback of not trusting doctors or
prescriptions anymore because the medicine isnt benefiting them or even making it worse.
While labeling has saved lives of those patients who merit attention, for many, it has blocked out
other possibilities in treatment. By labeling someone, they are given a reason to feel a specific

245way. And with that, they fall under a category that requires certain medication or other forms of

treatment (Heitler 1). Described by a PhD, Words have the power to define what we see,
potentially blocking us from seeing aspects that differ from the label (Heitler 1). As patients go
through the trial and error process with psychiatrists, they become frustrated with the efforts
being put in with no positive outcome. The pills begin to pile up with the many suggestions--or
250should we say guesses-- from the doctor. Forms of depression are often mistaken for other

symptoms in Asperger's Syndrome, obsessive-compulsive disorder, bipolar disorder, and many

more (Szalavitz 2). Commonly mistaken symptoms include chronic fatigue, concentration
issues, and irregular sleep patterns (Marini 1). Psychiatrists do the best they can to diagnose the
patient by these symptoms, but theyre not specific enough to a certain illness. Its not fair for the
255patients to be taking a handful of pills each morning if theyre not even sure it will help in any

way.
As people begin to disregard their treatment, they find other ways to cope with their
depression. Szalavitz, a neuroscientist, explains her experience in her article, Getting high not
only gave me comfort and a sense of belonging, but an obsession that wouldnt bore others when
260I pursued it endlessly. Instead of isolating me, this obsession allowed me to connect (Szalavitz

2) From this, she goes on to explain that her diagnoses of drug abuse problems were her first
correct labels from a doctor. Because doctors give labels with little consideration, patients turn

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towards drugs to feel a certain change-- a change that the diagnoses theyre receiving arent
giving them (Szalavitz 2). In Prozac Nation, a memoir by Elizabeth Wurtzel, she shares a story
265about her depression leading to drug abuse. After being given the wrong medication countless

times, she falls deeply into a reliance on hard drugs, such as cocaine, for a sense of belonging in
her college years. Over-labeling, especially when incorrect, seems to be an ongoing problem in
our diagnosing methods used to this day.
Thankfully, our rapidly changing world in technology is bringing us hopeful ideas on how the
270diagnosis of depression could change. SSRIs and blood tests are the new and promising science

on depression for the quickest and most accurate diagnosis possible. SSRIs (selective serotonin
reuptake inhibitors) are a dosage of a certain antidepressant that can change the brains
connectivity within hours of taking it(Bekiempis 2). Antidepressants can take up to a month to
work (Bekiempis 1). SSRIs, mostly sold under the name Lexapro reduced connectivity in
275most parts of the brain, but increased connectivity within the cerebellum and thalamus--the parts

of the brain associated with motor control and single regulation, respectively-- within hours
(Bekiempis 2). This antidepressant will allow scientists to compare brain connectivity to help
with depression research and treatment. Comparing the brains of patients who have used SSRIs
to those who have not will help us to understand if a patient should continue to take an SSRI or
280seek a new treatment (Bekiempis 2).

Another treatment that scientists are looking into are blood tests. By measuring blood levels
within nine different types of RNA(Main 2), scientists predict they will be able to successfully
diagnose depression and also decipher which patients could benefit from talk therapy and who
may be vulnerable to the condition in the first place (Main 2). Using 32 patients who were
285diagnosed with depression and 32 other normal people as a control group, scientists did a study

Depression

by collecting blood samples from all 64 patients. After observing the results, scientists found
that concentrations of these nine different chemicals were significantly different between the two
groups. (Main 2). These biomarkers within the blood levels will be able to determine who
suffers genetically and who may relapse from it in later years. With this new idea in mind, people
290will likely turn towards this practice, as it is more reliable and will be much quicker than the

months it takes for counseling (Main 2). Technology is becoming more and more dominant. So
why not put it to use in this dilemma of diagnosing mental illnesses? The results are
preliminary and these tests are not yet ready to become the top treatment within the doctors
office. But eventually, doctors will be more confident with the results. Counseling will then be a
295form of treatment only used for those who prove it necessary by looking at their blood tests

(Main 1).
Depression influences 10 percent of adults and is still an increasing statistic (Main 2). Being
such a common illness, it is important that doctors can confidently help patients feel a sense of
belonging during this dark state of mind. People may understand that depression is complex and
300difficult to know exactly what is wrong in every patient, but that is no excuse anymore with

scientists newest findings. The older treatment of counseling is no longer the most accurate way
to diagnose most patients. Im not saying we should get rid of it completely; it is still helpful for
some. However, by using SSRIs and blood tests, we now have an upcoming way to decipher
who needs what type of treatment. And with this, people like John wont be taking handfuls of
305antidepressants without knowing for sure that it will work. Being given accurate information and

diagnosis wouldve helped John and many others have the motivation to overcome depression.
This new and enabling research could very well lower the rising statistics of depression in our
world today.

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(113 lines)
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Works Cited

ADAA "Facts & Statistics | Anxiety and Depression Association of America, ADAA."Facts &
Statistics | Anxiety and Depression Association of America, ADAA. ADAA, n.d. Web. 04
May 2015. <http://www.adaa.org/about-adaa/press-room/facts-statistics>.
Bekiempis, Victoria. "One Dose of an Antidepressant Can Change Your Brain, Study Says."
Newsweek. N.p., 18 Sept. 2014. Web. 26 Apr. 2015.
<http://www.newsweek.com/antidepressants-can-change-your-brain-immediately-study271371>.
Depression: Out of the Shadows. Dir. Larkin McPhee. PBS, 2008. DVD.
Heitler, Susan. "Psychological Diagnosis: Dangerous, Desirable, or Both?" Psychology
Today. Resolution, Not Conflict, 3 Feb. 2012. Web. 06 Apr. 2015.
https://www.psychologytoday.com/blog/resolution-not-conflict/201202/psychologicaldiagnosis-dangerous-desirable-or-both
Kaye, Neil S. "Is Your Depressed Patient Bipolar?" Medscape. N.p., 2005. Web. 1 May 2015.
<http://www.medscape.com/viewarticle/507703_4>.
Main, Douglass. "First 'Blood Test for Depression' Holds Promise of Objective Diagnosis."

Depression

Newsweek. N.p., 16 Sept. 2014. Web. 26 Apr. 2015. <http://www.newsweek.com/firstblood-test-depression-holds-promise-objective-diagnosis-270951>.

Marini, Ariana. "10 Commonly Misdiagnosed Conditions." EverydayHealth. N.p., 28 Aug.
2014. Web. 3 May 2015.
<http://www.everydayhealth.com/pictures/commonly-misdiagnosed-conditions/#04>.
Mayo Clinic staff. "Depression (major Depressive Disorder)." Depression (major Depression)
Definition. Mayo Clinic, 17 Apr. 2015. Web. 24 May 2015.
<http://www.mayoclinic.org/diseases-conditions/depression/basics/definition/con-200329
77>.
Rijswijk, Eric Van. "Barriers in Recognising, Diagnosing and Managing Depressive and
Anxiety Disorders as Experienced by Family Physicians; a Focus Group Study." BMC
Family Practice. Springer Science+Business Media, 20 July 2009. Web. 07 Apr. 2015.
<http://www.biomedcentral.com/1471-2296/10/52>.
Szalavitz, Maia. "Viewpoint: My Case Shows Whats Right and Wrong With Psychiatric
Diagnoses | TIME.com." Time. Time, 17 May 2013. Web. 09 Apr.
2015.<http://healthland.time.com/2013/05/17/viewpoint-my-case-shows-whats-rightand- wrong-with-psychiatric-diagnoses/>.
WebMD. "Causes of Depression: Genetics, Illness, Abuse, and More." WebMD, n.d.
Web. 24 May 2015. <http://www.webmd.com/depression/guide/causes-depression>.

Depression

Tracy Turner <JTurner5@gmail.com>

Blood Tests
Tracy Turner <JTurner5@gmail.com>

Mon, May 1, 2017 at 1:33 PM

Dr. Jay M Brenner and staff:

I wanted to give you an update on John's progress. For the first time in three years, I have seen an
improvement in his mood. He's still not 100%, but I feel like we're finally on the right track. I just
wanted to thank you for suggesting the blood tests for John. We're hopeful that the testing has led us
to the correct diagnosis. Thank you again for your help.
Sincerely,
Tracy Turner

Title:____Speak Up__

DS Genre:__PSA/Digital Essay_______

Hour:__4th___ Name:__Rachel Carle_

Image

Voiceover and
URL

Transition to next
image

Visual effects

*black screen*

little to no
energy
my own video
feels hopeless

Soundtrack

Medicine by
Daughter

autofade

black and
white

Medicine by
Daughter

black and

Medicine by

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Depression

white

Daughter

my own video
changes habits
http://imgarcade.com/1/depressed-person-drinking/

pan
and
zoo
m

Medicin
e
by
Daughter

abuses drugs

Medicin
e
by
Daughter

https://www.youtube.com/watch?v=KCi1wITHcwY
abuses drugs (continued)

black
and
whit
e

https://www.youtube.com/watch?v=kFNdDc-qezo
"Over 80% of the people
with symptoms of clinical
depression are not receiving
any specific treatment for
their depression." -Healthline

Medicin
e
by
Daughter
Medicin
e
by
Daughter

http://www.healthline.com/health/depression/statistics
-infographic
my own video

Speak up for someone who cant.

https://www.youtube.com/watch?v=tpi5RoNmvTU

Digital Story Script

Speak up for someone who cant.

autofade

black
and
whit
e

Medicin
e
by
Daughter

black
and
whit
e

Medicin
e
by
Daughter

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Endnotes
Medical Examinations
I got the idea from this piece as I looked through my brothers endless piles of medical papers for his
depression from the Mayo Clinic (also found online). I thought that with these, I got a better
understanding of what type of information the doctors need in order to diagnose patients. I got this
information from some of my brothers papers in order to show a realistic diagnosis. I chose to show the
process of diagnosing through this genre because I feel that its simple to read and understand. It is also
very true to real life medical procedures.
Living Deep in the Well
I first got the idea for this piece from personal experience. Overall, this piece reflects the
exhaustion someone goes through with depression, describing what it personally feels like using a
metaphor to being stuck down in a well. My brother, who I see going through depression every day, was
my spark to writing something that everyone could relate to and understand what its like. The Mayo
Clinic provided me with a lot of the information included, such as symptoms and causes of depression. I
chose to write about the background of depression with a poem because its so common and people
already have some knowledge of what it is. This way, it could be a short, but strong piece to still intrigue
the reader without much repetition of what they already know.
The Only Escape
I originally got the idea for this piece from personal experience. Ive seen that my brother uses
other ways of coping for his depression than his antidepressants. And he is not the only one. I also got
many ideas from the memoir I read called Prozac Nation by Elizabeth Wurtzel. This book gave me
another example of drug abuse relating to depression. Given this information, I wrote this piece to inform
readers on how depression diagnosis can be a danger to patients, for it takes a long time to receive the
right treatment for an individual. I wanted to show the frustration parents have with a child going through
depression and drug abuse. So with that, I chose to do a narrative because I thought that using dialogue
would best get the point across.
E-mail
I got the idea for this genre from personal experience with my brother. My family knows how
frustrating and long the diagnosis process is for depression. And so when they do finally have an
understanding for what your child has, it would be very relieving to know your child will be improving
from there on out. Knowing what my mom would do, I wanted to bring out the same actions she would
pursue if some treatment seemed to work. Through this letter, I am able to convey the mothers
gratefulness for this new process of blood testing to help her son out with depression. I got the blood test
research from a Newsweek article online.
Speak Up
I got the idea for this piece by watching previous PSAs and also from some that Ive seen on TV. After
reading the memoir Prozac Nation by Elizabeth Wurtzel, I knew more about the dangers of depression
tying into drug abuse and suicide attempts. Because not all of my audience will get the opportunity to

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40
read that book, I want to bring some of that message to my PSA/digital essay. I chose to do my
PSA/digital essay about suicide awareness because it is a very emotional subject. Because of this, it will
help to show video with a strong statement at the end to grab the viewers attention.

Bibliography
ADAA "Facts & Statistics | Anxiety and Depression Association of America, ADAA."Facts &
Statistics | Anxiety and Depression Association of America, ADAA. ADAA, n.d. Web. 04
May 2015. <http://www.adaa.org/about-adaa/press-room/facts-statistics>.
Bekiempis, Victoria. "One Dose of an Antidepressant Can Change Your Brain, Study Says."
Newsweek. N.p., 18 Sept. 2014. Web. 26 Apr. 2015.
<http://www.newsweek.com/antidepressants-can-change-your-brain-immediately-study271371>.
Depression: Out of the Shadows. Dir. Larkin McPhee. PBS, 2008. DVD.
Heitler, Susan. "Psychological Diagnosis: Dangerous, Desirable, or Both?" Psychology
Today. Resolution, Not Conflict, 3 Feb. 2012. Web. 06 Apr. 2015.
https://www.psychologytoday.com/blog/resolution-not-conflict/201202/psychologicaldiagnosis-dangerous-desirable-or-both
Kaye, Neil S. "Is Your Depressed Patient Bipolar?" Medscape. N.p., 2005. Web. 1 May 2015.
<http://www.medscape.com/viewarticle/507703_4>.

Main, Douglass. "First 'Blood Test for Depression' Holds Promise of Objective Diagnosis."
Newsweek. N.p., 16 Sept. 2014. Web. 26 Apr. 2015. <http://www.newsweek.com/firstblood-test-depression-holds-promise-objective-diagnosis-270951>.

Depression

Marini, Ariana. "10 Commonly Misdiagnosed Conditions." EverydayHealth. N.p., 28 Aug.

2014. Web. 3 May 2015.
<http://www.everydayhealth.com/pictures/commonly-misdiagnosed-conditions/#04>.
Mayo Clinic staff. "Depression (major Depressive Disorder)." Depression (major Depression)
Definition. Mayo Clinic, 17 Apr. 2015. Web. 24 May 2015.
<http://www.mayoclinic.org/diseases-conditions/depression/basics/definition/con-200329
77>.
Rijswijk, Eric Van. "Barriers in Recognising, Diagnosing and Managing Depressive and
Anxiety Disorders as Experienced by Family Physicians; a Focus Group Study." BMC
Family Practice. Springer Science+Business Media, 20 July 2009. Web. 07 Apr. 2015.
<http://www.biomedcentral.com/1471-2296/10/52>.
"Suicide and Suicidal Thoughts." Mayo Clinic.
Http://www.mayoclinic.org/diseases-conditions/suicide/basics/prevention/con-20033954,
19 May 2015. Web. <http%3A%2F%2Fwww.mayoclinic.org%2Fdiseases-conditions
%2Fsuicide%2Fbasics%2Fprevention%2Fcon-20033954>.
Szalavitz, Maia. "Viewpoint: My Case Shows Whats Right and Wrong With Psychiatric
Diagnoses | TIME.com." Time. Time, 17 May 2013. Web. 09 Apr.
2015.<http://healthland.time.com/2013/05/17/viewpoint-my-case-shows-whats-right-andwrong-with-psychiatric-diagnoses/>.
"Unhappiness by the Numbers: 2012 Depression Statistics." Depression Statistics:
Unhappiness by the Numbers [INFOGRAPHIC]. Healthline, 2012. Web. 20 May 2015.

Depression

<http://www.healthline.com/health/depression/statistics-infographic>.
WebMD. "Causes of Depression: Genetics, Illness, Abuse, and More." WebMD, n.d.
Web. 24 May 2015. <http://www.webmd.com/depression/guide/causes-depression>.
"What Makes Us Special!" Upstate Golisano Children's Hospital. N.p., n.d. Web. 24 May 2015.
<http://www.upstate.edu/gch/>.
Wurtzel, Elizabeth. Prozac Nation: Young and Depressed in America. N.p.: Riverhead Trade,
1994. Print.

Pictures:
http://logo-kid.com/hospital-logo-red-cross.htm
http://www.upstate.edu/marketing/brandresources/logos.php
http://hdimagelib.com/dark+road+background

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