This Is What to Expect When Seeing a Doctor for Depression

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In the United States, over 7 percent of adults and children (over the age of 12) have experienced depression within any two-week period. In fact, depression is one of the most common chronic health conditions listed by doctors on their patients' medical records. 

While depression is common, if you think you have it, you may be unsure about where to begin. Here are the steps to getting your mental health treated, so you can feel well.

Seeing Your Primary Care Doctor

If you suspect you may have depression, your first visit should be to your family or primary care physician for a thorough checkup. While most doctors do screen for depression, it's best to be forward and tell your doctor upfront your concerns about your mood. Your doctor is there to help you, so do not hold back. 

With that, your doctor may ask you several questions related to your depression. Examples of these questions may include:

  • How long have you been feeling sad or down?
  • Are you sleeping more than usual or having difficulty sleeping? 
  • How is your appetite? Have you lost weight or gained weight?
  • How is your energy level?
  • Are you having trouble concentrating or making decisions?
  • Do you think of death or have thoughts of suicide? 

Your answers to these questions (and others) will help your doctor pinpoint whether or not you have major depressive disorder, often referred to simply as depression.

Even so, before confirming a diagnosis, your doctor will need to rule out other health problems. This is because there are symptoms of several medical conditions that can mimic those of depression. This is especially true in older adults with new onset depression.

Some of these health conditions include:

  • Vitamin deficiencies (for example, vitamin B12 deficiency)
  • Anemia
  • Low blood sugar
  • Hypothyroidism
  • Calcium or other electrolyte abnormalities
  • Kidney or liver problems

While blood tests cannot be used to diagnose depression, they may be ordered by your doctor to rule out some of these above conditions.

Less commonly, an imaging test may be ordered, like a brain  MRI, to rule out structural brain diseases, like stroke, especially if there are neurological signs on a person's physical examination or evidence of cognitive problems. 

In addition, some medications may cause symptoms of depression as a side effect. Be sure to tell your doctor all of the medications you are taking, including both prescription and over-the-counter drugs.  

Lastly, it's worthy to note that sometimes other mental health conditions can be difficult to tease apart from depression.

For instance, bipolar disorder may be misdiagnosed initially as depression. This is because symptoms of mania may be overlooked, as a person's  depressive symptoms are the ones that feel so bad and first bring them in initially. Substance abuse, either intoxication or withdrawal, can also cause symptoms that overlap with depression. 

Try to remain patient as your doctor sorts through your symptoms.

Referral to a Mental Health Professional

After a complete medical history and physical examination, if your doctor diagnoses you with depression, you may then be referred to a mental health professional, like a psychiatrist

The role of a psychiatrist is to further evaluate your mood and determine whether or not medication is needed. If you would also benefit from psychotherapy (research suggests that the combination of medication and therapy is most effective for treating depression), psychiatrists are generally able to handle this as well, although some may elect to refer you to another mental health professional, like a psychologist.

While some people will do fine being treated by their primary care physician, others may benefit from seeing a psychiatrist especially if symptoms are not improving with the first trial of an antidepressant, or the depression is severe from the start.  

In short, if you are diagnosed with depression, it seems prudent to start with, or at least get a referral to, a mental health professional.

Treatment of Depression Is Complex

It's important to note the treatment of depression is not as simple as writing a prescription for Prozac (fluoxetine). The individual causes of depression are diverse and poorly understood. The medications used to treat it are just as diverse, so matching a drug with an individual is not a clear-cut decision.

A person's specific symptoms, co-existing illnesses, tolerance of side-effects, and medications previously tried are just a few factors that are considered when your doctor chooses your antidepressant. 

Also, treatment can take some time. While many people begin to feel better within one to two weeks, it can take six to twelve weeks to feel the full effect of your medication.

Even so, be sure to follow closely with your doctor, especially if you are experiencing bothersome side effects. Also, if you are noticing very little or no improvement in your symptoms after two to four weeks, your doctor may increase your dose, add another medication to increase its effect, or switch your medication. 

A Word From Verywell

The most important thing to remember about seeking depression treatment is simply to speak up and ask. Depression is not a sign of weakness or laziness. It's a sign that something is out of balance. With proper treatment, which usually entails the two-pronged approach of medication and psychotherapy, you can feel well again. 

Sources:

Centers for Disease Control and Prevention. (2016). National Health Statistics: Depression. 

Cuijpers P, Dekker J, Hollon SD, Andersson G. Adding psychotherapy to pharmacotherapy in the treatment of depressive disorders in adults: a meta-analysis. J Clin Psychiatry. 2009;70(9):1219.

Maurer DM, Screening for Depression. Am Fam Physician. 2012 Jan 15;85(2):139-44.

Simon G. (2017). Patient education: Depression treatment options for adults (Beyond the Basics). Roy-Byrne PP, ed. UpToDate. Waltham, MA: UpToDate Inc.

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