What Kind of Doctor Is Best for Treating Depression?

Making the Best Choice to Help Your Recovery

Teenage girl (16-17) talking to therapist
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The treatment of mood disorders is not as simple as diagnosing depression and writing a prescription for Prozac. 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. Individual symptoms, co-existing illness, tolerance of side-effects, and medications previously tried are just a few factors that must be considered.

 

Depression is a Complex Problem

Then there are the difficulties in making an exact diagnosis. Bipolar disorder, in particular, may be misdiagnosed, especially if patients fall on the edge of the criteria listed in the Diagnostic and Statistical Manual. Symptoms of mania may be overlooked because depressive symptoms are the ones that feel so bad and first bring a patient in for help. Symptoms of bipolar disorder may also be confused with other disorders. 

Add in the fact that there are no brain scans or blood tests one can take to make a definitive diagnosis. Doctors must rely on a set of signs and symptoms as well as the patient's history. Diagnosing and treating depression and bipolar disorder is not a simple matter at all.

When one realizes the complexity of the matter, it becomes easy to see that treating mood disorders is not an exact science. Rather it is an art form requiring a combination of patience, knowledge, judgment, willingness to try new treatments, the ability to network with peers and a desire to keep up with current developments in the field.

What Your Doctor Doesn't Know Can Hurt

Studies show that 74% of people seeking help for depression will first go to their primary care physician, a doctor who does not specialize in these conditions, but rather must be a variable jack of all trades, treating and screening for a wide range of illnesses.

Your family doctor simply does not have the time or energy needed to keep up with the specialized knowledge necessary to treat mood disorders. 

Of these cases of depression diagnosed by primary care physicians, as many as 50% are misdiagnosed. Considering that depression can have a fatal outcome if not properly diagnosed and treated, these are some sobering statistics.

Of course, some people will do just fine with their primary care physician. They will get a proper diagnosis and may even be fortunate enough to respond to the first medication that their physician prescribes. 

In short, it seems prudent to start with, or at least get a referral to, a mental health professional who specializes in the diagnosis and treatment of mental health disorders to find the best treatment plan for you.

Who's an Expert?

So, whom should you see to ensure that you are in the hands of an expert? Although there is some controversy over whether psychotherapy, medication or a combination of both are best for depression, there is really one type of doctor who is qualified to treat depression and other mood disorders using medications: a psychiatrist.

A psychologist specializes in talk therapy and while also qualified to treat depression, is not a medical doctor and cannot prescribe drugs.

If you are uncertain whether you need medication, it is best to begin your treatment under the care of a psychiatrist. If you will also benefit from talk therapy, psychiatrists are generally able to handle this as well, although some may elect to refer you to another therapist.

The Primary Care Physicians's Important Role

Keep in mind that you should not skip your primary care provider altogether. In fact, depending upon your insurance coverage, you may have to see him/her in order to get a referral. Your primary care provider does play a very important role, both in screening you for possible mood disorders and in screening for other illnesses that may mimic depression symptoms. Once it is determined that you are healthy and may possibly have a mood disorder, however, your doctor should give you a referral to a qualified specialist.

If your doctor does not offer to make this referral, insist upon it. After all, you are paying your doctor for a service. You have the right to expect care from a qualified expert.

Sources:

Birndorf, Catherine. Bipolar Disorder: On the Edge of DSM-V. Online Coverage from the 150th Annual Meeting of the American Psychiatric Association May 18 - 21, 1997.

MHI Ask the Expert. Difficulties in Diagnosing Bipolar Disorder.

MHI Ask the Expert. Bipolar with Borderline

Worcester, Sharon. Rule Out Mimics Before Diagnosing ADHD. Pediatric News, 32(2):31, 1998.

Scientific American- Ask the Experts. Is there a biochemical test that accurately diagnoses bipolar disorder?

OnHealth Medical Advisory Board. Depression: Causes and Treatments.

Health Oasis, Mayo Clinic. Antidepressant Medications: Are They for You? 

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