The fifth phase is information management, whereby one has to organize information that has been gathered in some manner to ensure easy retrieval and use in the future. The last phase is information use, in which one will synthesize information found across various resources, draw conclusions, and locate the answer to his or her original question and/or the content that fulfills the information need. This phase also often involves implementation, such as using the information to solve a health problem; make health-related decisions; identify and engage in behaviors that will help a person to avoid health risks; share the health information found with family members and friends who may benefit from it; and advocate more broadly for personal, family, or community health.
The Importance of Health Literacy
The conception of health has moved from a passive view (someone is either well or ill) to one that is more active and process based (someone is working toward preventing or managing disease). Hence, the dominant focus has shifted from doctors and treatments to patients and prevention, resulting in the need to strengthen our ability and confidence (as patients and consumers of health care) to look for, assess, understand, manage, share, adapt, and use health-related information. An individual’s health literacy level has been found to predict his or her health status better than age, race, educational attainment, employment status, and income level (National Network of Libraries of Medicine, 2013). Greater health literacy also enables individuals to better communicate with health care providers such as doctors, nutritionists, and therapists, as they can pose more relevant, informed, and useful questions to health care providers. Another added advantage of greater health literacy is better information-seeking skills, not only for health but also in other domains, such as completing assignments for school.
Sources of Health Information: The Good, the Bad, and the In-Between
For generations, doctors, nurses, nutritionists, health coaches, and other health professionals have been the trusted sources of health information. Additionally, researchers have found that young adults, when they have health-related questions, typically turn to a family member who has had firsthand experience with a health condition because of their family member’s close proximity and because of their past experience with, and trust in, this individual. Expertise should be a core consideration when consulting a person, website, or book for health information. The credentials and background of the person or author and conflicting interests of the author (and his or her organization) must be checked and validated to ensure the likely credibility of the health information they are conveying. While books often have implied credibility because of the peer-review process involved, self-publishing has challenged this credibility, so qualifications of book authors should also be verified. When it comes to health information, currency of the source must also be examined. When examining health information/studies presented, pay attention to the exhaustiveness of research methods utilized to offer recommendations or conclusions. Small and nondiverse sample size is often—but not always—an indication of reduced credibility. Studies that confuse correlation with causation is another potential issue to watch for. Information seekers must also pay attention to the sponsors of the research studies. For example, if a study is sponsored by manufacturers of drug Y and the study recommends that drug Y is the best treatment to manage or cure a disease, this may indicate a lack of objectivity on the part of the researchers.
The Internet is rapidly becoming one of the main sources of health information. Online forums, news agencies, personal blogs, social media sites, pharmacy sites, and celebrity “doctors” are all offering medical and health information targeted to various types of people in regard to all types of diseases and symptoms. There are professional journalists, citizen journalists, hoaxers, and people paid to write fake health news on various sites that may appear to have a legitimate domain name and may even have authors who claim to have professional credentials, such as an MD. All these sites may offer useful information or information that appears to be useful and relevant; however, much of the information may be debatable and may fall into gray areas that require readers to discern credibility, reliability, and biases.
While broad recognition and acceptance of certain media, institutions, and people often serve as the most popular determining factors to assess credibility of health information among young people, keep in mind that there are legitimate Internet sites, databases, and books that publish health information and serve as sources of health information for doctors, other health sites, and members of the public. For example, MedlinePlus (https://medlineplus.gov) has trusted sources on over 975 diseases and conditions and presents the information in easy-to-understand language.
The chart here presents factors to consider when assessing credibility of health information. However, keep in mind that these factors function only as a guide and require continuous updating to keep abreast with the changes in the landscape of health information, information sources, and technologies.
The chart can serve as a guide; however, approaching a librarian about how one can go about assessing the credibility of both print and online health information is far more effective than using generic checklist-type tools. While librarians are not health experts, they can apply and teach patrons strategies to determine the credibility of health information.
All images from flaticon.com
With the prevalence of fake sites and fake resources that appear to be legitimate, it is important to use the following health information assessment tips to verify health information that one has obtained (St. Jean et al., 2015, p. 151):
Don’t assume you are right: Even when you feel very sure about an answer, keep in mind that the answer may not be correct, and it is important to conduct (further) searches to validate the information.
Don’t assume you are wrong: You may actually have correct information, even if the information you encounter does not match—that is, you may be right and the resources that you have found may contain false information.
Take an open approach: Maintain a critical stance by not including your preexisting beliefs as keywords (or letting them influence your choice of keywords) in a search, as this may influence what it is possible to find out.
Verify, verify, and verify: Information found, especially on the Internet, needs to be validated, no matter how the information appears on the site (i.e., regardless of the appearance of the site or the quantity of information that is included).
Health literacy comes with experience navigating health information. Professional sources of health information, such as doctors, health care providers, and health databases, are still the best, but one also has the power to search for health information and then verify it by consulting with these trusted sources and by using the health information assessment tips and guide shared previously.
Mega Subramaniam, PhD
Associate Professor, College of Information Studies, University of Maryland
References and Further Reading
American Association of School Librarians (AASL). (2009). Standards for the 21st-century learner in action. Chicago, IL: American Association of School Librarians.
Hilligoss, B., & Rieh, S.-Y. (2008). Developing a unifying framework of credibility assessment: Construct, heuristics, and interaction in context. Information Processing & Management, 44(4), 1467–1484.
Kuhlthau, C. C. (1988). Developing a model of the library search process: Cognitive and affective aspects. Reference Quarterly, 28(2), 232–242.
National Network of Libraries of Medicine (NNLM). (2013). Health literacy. Bethesda, MD: National Network of Libraries of Medicine. Retrieved from nnlm.gov/outreach/consumer/hlthlit.html
Ratzan, S. C., & Parker, R. M. (2000). Introduction. In C. R. Selden, M. Zorn, S. C. Ratzan, & R. M. Parker (Eds.), National Library of Medicine current bibliographies in medicine: Health literacy. NLM Pub. No. CBM 2000–1. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services.
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br /> St. Jean, B., Subramaniam, M., Taylor, N. G., Follman, R., Kodama, C., & Casciotti, D. (2015). The influence of positive hypothesis testing on youths’ online health-related information seeking. New Library World, 116(3/4), 136–154.
St. Jean, B., Taylor, N. G., Kodama, C., & Subramaniam, M. (February 2017). Assessing the health information source perceptions of tweens using card-sorting exercises. Journal of Information Science, 44(2): 148–164. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/0165551516687728
Subramaniam, M., St. Jean, B., Taylor, N. G., Kodama, C., Follman, R., & Casciotti, D. (2015). Bit by bit: Using design-based research to improve the health literacy of adolescents. JMIR Research Protocols, 4(2), paper e62. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464334/
Valenza, J. (2016, November 26). Truth, truthiness, and triangulation: A news literacy toolkit for a “post-truth” world [Web log]. Retrieved from http://blogs.slj.com/neverendingsearch/2016/11/26/truth-truthiness-triangulation-and-the-librarian-way-a-news-literacy-toolkit-for-a-post-truth-world/
Common Misconceptions about Depression
1. Depression Is All in Your Head
One of the reasons so many people have trouble taking depression seriously is that it is a largely invisible disorder. Despite being able to describe the symptoms you might be feeling, there are no independent medical tests that can be used to prove that you are really depressed. As a result, depressed people are often told they can simply “get over it” if they try hard enough and, if that doesn’t work, that they are somehow at fault for not being sufficiently strong-willed or are just seeking attention. Even family doctors may just prescribe a medication such as Prozac in the hope of solving the problem without exploring the underlying reasons for the depression. Question 2 offers an overview of the different types of clinically diagnosable depression.
2. Depression Is the Same as Sadness
While everyone may think they know what depression is, they are usually just talking about specific symptoms such as sadness or chronic fatigue. Even though these symptoms are often found in clinical depression, it’s important not to assume that having these symptoms mean that you are suffering from depression. And, just as importantly, it is quite possible to be suffering from clinical depression even if you aren’t feeling these specific symptoms. As one example, feeling sad is a normal part of the human existence and can occur whenever we experience a setback or some sort of disappointment. For people dealing with depression, problems with emotional numbing or despondency may prevent any kind of natural emotions from coming out, including feelings of sadness or joy. Considering how complicated the process of diagnosing depression can be, this needs to be left up to a trained mental health professional. Question 3 provides more information about the differences between sadness and depression.
3. Only Weak People Get Depressed
This is one of the most heartbreaking misconceptions faced by people dealing with depression. Many otherwise well-meaning people have difficulty accepting that depression is a disease and feel that people dealing with depression simply lack the willpower to get over it. Whether due to genetics, upbringing, poor environment, or emotional problems stemming from trauma, many people are particularly vulnerable to depression and accusing them of lacking self-control makes recovery much harder than it needs to be. As we will see in later sections of this book, depression isn’t just a matter of “getting the blues,” and it isn’t something that only happens to people who aren’t strong enough to “get over it” (as far too many friends and family members might wrongly suggest). Rather than being a sign of weakness, dealing with depression often means forcing yourself to get out of bed, dress yourself, and still do all the things you need to do, even while you wonder why you should make the effort. Coming to terms with these feelings and forcing yourself to keep going, not to mention finding the energy to find help when you need it, is the very opposite of weakness. Only someone who experiences clinical depression can truly understand this. Question 5 discusses which groups of people may be at higher risk of developing clinical depression.
4. Cheering Someone Up Is the Best Way to Help with Depression
Many people, when faced with someone dealing with depression, often have no idea of what to do or say that can make this kind of pain go away. While trying to cheer a depressed person up may seem like the right thing to do, it really isn’t. As we’ve already seen, someone who is clinically depressed isn’t just “feeling the blues,” and trying to rely on humor or good cheer to make it go away can do more harm than good. If you know someone who is depressed, the best way to help is to listen to that person and show that you care about what he or she is going through. Unfortunately, many people may not understand what is happening and, as a result, often find themselves saying the wrong thing or giving bad advice. This is why people who really want to help someone overcome depression needs to start by educating themselves about what depression is and how to help. Reading this book is one way to start, and the Directory of Resources contains other resources as well. For more information about how to get help for yourself or a loved one, see Questions 35, 46, and 47.
5. People Who Are Depressed Are “Crazy”
While clinical depression is considered to be a form of mental illness, that doesn’t mean that any of the popular stereotypes about crazy people are going to be true. Most people who are depressed can manage their lives just fine with the right help, whether in the form of medication or counseling (or both, preferably). Depression isn’t the same thing as psychosis, and it doesn’t necessarily mean that they’re inclined to harm themselves or anyone else. Even though some people with depression may begin displaying psychotic symptoms or threaten suicide, this is something that needs to be assessed by a qualified mental health professional who can provide the needed treatment. No matter how worried you are about someone who you know is depressed, you need to respect their own judgment about what is best for them. See Questions 13 to 25 for more information about the many causes and risk factors associated with depression.
Questions and Answers
General Information
1. What is depression?
According to the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), there are a wide range of possible diagnoses that can be given to someone who is clinically depressed. The most common feature of all these conditions is the “presence of sad, empty, or irritable mood, accompanied by somatic or cognitive changes that significantly affect the individual’s capacity to function.” In other words, it isn’t enough just to feel depressed; the symptoms also need to be severe enough to prevent sufferers from being able to function, whether on their own, with their families, or at work or school.
But people feeling depressed can experience other symptoms as well. Common symptoms include sadness, irritability, anxiety, apathy, loss of energy, loss of pleasure in things previously enjoyed, changes in sleep and appetite, recurring thoughts of death, physical agitation, feelings of worthlessness, and concentration problems. While all these symptoms can occur in depression, a depressed mood and loss of pleasure are usually considered to be the most common symptoms, and they are the ones most likely to lead to a depression diagnosis.
Though people in their late twenties to mid-thirties seem particularly vulnerable to depression, symptoms can develop at any age. Older adults and even teenagers and young children have been known to commit suicide because they couldn’t handle the symptoms they were experiencing.
As we will see in the next question, there are numerous different diagnoses that can be given to someone who is experiencing symptoms of depression. It is typically the job of a qualified mental health professional to make that diagnosis, and over time, the diagnosis can change as well. Though these diagnostic labels can seem arbitrary, they do play a role in the kind of treatment that someone might need to get better and can also provide some clues as to the underlying cause as well.
Among the things a health professional will look at in making an assessment is whether or not the depression has an obvious cause. Many people will develop reactive depression following a traumatic experience or due to grief after the death of a loved one. While this kind of grief is certainly common, it can also lead to a deep depression that may require medication or supportive counseling. On the other hand, depression can also strike out of the blue with no apparent cause at all. This is often called endogenous depression (literally coming from within), though many people developing depression may show signs of both.
Depression Page 2