“PDD can be difficult to diagnose since these individuals are typically still functioning in terms of work, parenting, and other responsibilities,” says Katie Munger, LPC, Director of Outpatient Services at the Hamilton outpatient site. “But they’re really just getting through each day without feeling any joy or hope. PDD can be effectively treated, especially when pairing the insight of a psychiatrist and a therapist.”
In some cases, patients may not even recognize PDD in themselves, since it doesn’t fit the more common recognition of depression as an inability to function. Sometimes those with PDD seek therapy for an ineffective coping mechanism such as substance use. Others may wish to hide their symptoms or may be unwilling to take the necessary time from their busy schedules to get the appropriate level of care.
According to Munger, it’s similar to Luisa’s character in the Encanto movie (see page 4) – when those who have underlying pain/discomfort give precedence to their responsibilities and don’t seek help, it can be a house of cards waiting to crumble.
Using Motivational Interviewing
It’s important for patients experiencing PDD symptoms to seek medical expertise to rule out issues like an autoimmune disease or a thyroid condition. When PDD is present, providers may need to help patients understand the benefits of more consistent therapy sessions, intensive outpatient care, or even inpatient care if suicidal ideation is present. In these situations, motivational interviewing techniques can be valuable.
“Patients may have a laundry list of reasons why they can’t fit the level of treatment they need into their schedules,” says Munger. “But instead, we can use a motivational interviewing approach: ask them to think of the three best reasons why they should consider taking that time to help themselves.”
In motivational interviewing, conversation is structured around change to help patients recognize that they have the power to change their lives for the better. It instills confidence so that patients can articulate their own reasons for change, discover motivation, and create momentum. Providers can serve as effective guides on this journey.
“We can gently encourage patients with PDD to see the benefits of broader care while respecting the fact that they are still able to function – because everyone deserves to feel not only contentment, but joy in their lives,” says Munger.
