Depression was measured by a scale called the PHQ-9. It has proved controversial because it was developed with the support of Pfizer, a pharmaceutical company. However, it is widely-used in psychological research and is used here to allow us to compare ‘like-with-like’. In other words, we can compare AV paramedics’ depression scores with the other types of people in research studies that used the PHQ-9.
The PHQ-9 has a range of scores from 0-27 so take a look at yours. Higher scores reflect more depressive symptoms. Following the ‘traffic light’ risk system of risk if your score is recorded in red your score has passed a cutoff used to identify someone who is said to be depressed. Remember, if we all have good days and bad days one red score does NOT mean you have a mental disorder, only that when you completed it your scores were close to those of someone with a diagnosis of depression – that’s all.
The purpose of measuring depression here is due to its link to suicide, something we hope to prevent. Very few people with a high PHQ-9 score are suicidal so even if your score came up in red the well-being scores are looked at as a counterbalance to consider what is protective, positive and different about you. If you do feel suicidal there is information at the foot of this page for support and someone to talk to.
Anxiety was measured by a scale called the GAD-7. Like the PHQ-9 it is controversial for similar reasons but also widely used in research hence including it here.
The GAD-7 has a range of scores from 0-21. Higher scores mean more anxiety symptoms and when the highest level is reached your score is recorded in red in keeping with the traffic-light system of risk. If your score for ‘Anxiety’ is red it means you reported a similar number and frequency of symptoms as someone who has phobias or is prone to panic. It does NOT mean you have a mental disorder, only that your scores are in the same region as someone who probably has. With life’s ups-and-downs it might be misleading to look at one score at one time and draw serious conclusions about it.
The purpose of measuring anxiety is because it is associated with fear and panic, something we hope to reduce. Most people with high scores on the GAD-7 are not paranoid or panic-stricken so if your score came up in red the other measures can help us see what might be counteracting the anxiety. If you do feel panic or dread for the future there is information at the foot of this page to find support and someone to talk to.
Posttraumatic stress disorder (PTSD)
Low = 18; High = 108
Think of this as a measure of ‘character’ with a range of scores from 18-108. If you’re interested in philosophy you might know about Aristotle, virtue and eudaimonism. This is a modern way of measuring those qualities and the higher the score, the more of those qualities you reported having. This scale is made up of autonomy, positive relations with others, self-appreciation, purpose in life, control over your environment and personal growth. These are not ‘happy-clappy’ feel-good qualities, more the satisfaction that comes with achievement after being challenged. Given the concerns that might be raised for having high scores on depression or anxiety (see above) these six aspects of character might oppose or overcome them.
If you scored low on ‘Psychological Wellbeing’ (e.g., 70 or less) you might want to reflect on your work, relationships and attitude to yourself to see what you might change to get more from life. If you have a score of 70 or less, and a red score on depression or anxiety, you might benefit from discussing your views on life with someone supportive. Information links to contact someone to do that is at the foot of the page.
Low = 3; High = 18
This quality if one of independence, especially in knowing your own mind and speaking up even when your views might not be welcome or popular. A low-scorer on autonomy is likely ‘going with the crowd’ or ‘keeping the peace’ rather than expressing their personal and original thoughts.
Low = 3; High = 18
Keeping on top of life’s routine tasks and nor feeling overwhelmed for long by how much there is to do is a reflection of environmental mastery. Simply put, if we feel that we are acting on the world rather than it is acting on us we probably feel we have a degree of control that lets us pursue our goals and interests rather than sacrifice them to keep solving problems that feel threatening.
Low = 3; High = 18
The sense that there is, and always will be, so much to learn and being happy knowing that implies that skills, capacities and abilities can be replaced or improved on. Growth implies change which suggests being able to adapt in an unpredictable world and give up an ability that no longer serves us to learn another that might. Growth runs counter against the notion of being ‘stuck’ (as in depression or anxiety) because it is a dynamic process of positive change with no predictable limits.
POSITIVE RELATIONS WITH OTHERS
Low = 3; High = 18
The willingness of relying on others and providing assistance to them when needs demand lies at the heart of social support. Social support (according to the practitioner Sidney Cobb) is ‘information leading the individual to believe that they are loved, valued and cared for in a network of mutual obligations’. The health benefits of social support are well documented and widely reported so finding high scores on this measure would imply a network of supportive others is available. Such a network is likely to contribute to other factors in well-being, especially in the control implied in a strong sense of environmental mastery.
PURPOSE IN LIFE
Low = 3; High = 18
Another dynamic quality of well-being is having a purpose, and one that likely gives meaning to life’s activities. Having a purpose is not the same as having achievements, so it suggests that striving itself is instrumental in developing this quality. Linked to growth, autonomy and relations with supportive others the effort in rising to a challenge seems likely to feed lessons back to the individual that in turn strengthens the other aspects of well-being.
High scores on self-appreciation suggest someone not being too hard on themselves for a lack of achievement. Self-criticism and self-denigration permeate the literature on mental health problems so a low score might invite closer scrutiny of the ‘self-talk’ someone engages in or how they present themselves to others. High scores imply an ability not to assume fault in themselves for disappointments and also to find satisfactoin in what was achieved, regardless of its magnitude.
Think of this as a measure of ‘character’ with a range of all six prior scores now going from 18-108. If you’re interested in philosophy you might know about Aristotle, virtue and eudaimonism. This addition of six aspects of well-being is a modern way of measuring those qualities and the higher the score, the more of those qualities you reported. You now know that scale is made up of autonomy, positive relations with others, self-appreciation, purpose in life, control over your environment and personal growth. These are not ‘happy-clappy’ feel-good qualities, more the satisfaction that comes with achievement after being challenged. Given the concerns that might be raised for having high scores on depression or anxiety (see above) you might now see how these six aspects of character might oppose or undermine them.
If you scored low (e.g., 70 or less) you might want to reflect on your work, relationships and attitude to life to see what you might change to get more from living. If you also have a red score on depression or anxiety, you might benefit from discussing your losses and disappointments with someone willing to listen without judging you. Information on contacting someone to ask for that is presented below.
Contacts and Resources of further support
Your employer’s EAP for a practitioner or counsellor
ICISF accredited CISM (peer-support) team
LifeLine Tel: 13 11 14
Beyond Blue Tel. 1300 224 636
Lifeline Aotearoa Tel: 09 5222 999 (Auckland) or 0800 543 354 (outside Auckland)
National Suicide Prevention Hotline Tel: 1 800 273 8255