Depression is a fact of life for millions of Americans. But how do you know if you’re depressed or just going through a rough patch? According to the CDC, depression affects 16 million American adults each year, and one in six adults will experience depression at some point in their life. More and more primary care doctors are on the front lines of helping patients navigate their mental healthcare. Up to 80 percent of patients seeking behavioral healthcare turn to their trusted primary care physician. Many patients do best with a cooperative approach, combining therapy from a licensed counselor with medications prescribed in the primary care setting. Whether or not medication is right for you, your primary care doctor is an excellent first resource if you think you might be depressed.
What Is Depression?
We all get sad and have bad days. When feelings of sadness or anxiety interfere with our day-to-day functioning, it might be clinical depression. Clinical depression is a treatable medical condition often related to brain structure, brain chemistry and genetics. Some of the risk factors for depression include:
- Trauma and significant life changes
- Hormone levels (often associated with pregnancy and menopause in women)
- Chronic illnesses, including cancer, stroke, or chronic pain
- Taking certain medications for other health conditions
- Alcohol, drug use and smoking
What Are The Symptoms of Depression?
Patients often ask how to distinguish an occasional bout of the blues from clinical depression. If you have one or more symptoms, your primary care doctor is an excellent first call. She’ll review your symptoms and discuss treatment options, including referrals for mental health services.
- Feeling sad or anxious all the time
- Trouble focusing or making decisions
- Not wanting to do activities you used to enjoy
- Having difficulty falling or staying asleep
- Sleeping too much and feeling tired throughout the day.
- Overeating or loss of appetite
- Experiencing suicidal thoughts or feelings of worthlessness
Do I Need Antidepressants?
Since the rise in popularity of Prozac in the 90s, antidepressants have become seemingly ubiquitous. They’re often lifesaving treatments for patients with severe mental health challenges and can help us function and enjoy life in the face of clinical depression. Antidepressants act on neurotransmitters, chemicals in your brain that impact your mood, including serotonin, norepinephrine and dopamine. In a nutshell, they help improve the pathways in your brain that regulate your mood. Antidepressants usually work best when paired with psychotherapy or counseling. Doctors have more options than ever in prescribing antidepressants, and different categories work in very different ways. Some patients need to try several medications before finding the right fit. An initial trial and error period is normal, and many drugs take four weeks or more before patients experience a noticeable effect.
Can My Primary Care Doctor Treat My Depression?
Primary care doctors are key players in helping patients get the mental healthcare they need. They receive special training to allow them to prescribe antidepressants for their patients. Your primary care physician knows your medical history and current medications and is often ideally suited to help identify the best treatment for depression. Many primary care doctors recommend a mixed approach, combining medication with psychotherapy or counseling. Talking with a licensed therapist is usually the best first step if you have depression symptoms. If that doesn’t work, your primary care physician can prescribe medication to complement your talk therapy.
Therapists have valuable tools for supporting mental health that don’t involve medication, including coping skills and behavior modification strategies. Therapy helps us address challenging thoughts and feelings and cope with stress using techniques like Cognitive Behavior Therapy. Talking with a licensed counselor is a powerful first step.
“I suggest they first try therapy and then come see me if it’s not totally successful. It’s important to really look into this and the causes and try to address them instead of just covering or masking the symptoms. Often, a combination of both therapy and medication is most effective,” says Dr. Mamta Ojha, a primary care physician and director of Norvinia Health.
Some patients choose a psychiatrist or a medical doctor who can provide therapy and prescribe medications. However, more and more people are choosing to get therapy from other licensed counselors (including licensed clinical social workers) who can’t prescribe medication. Working with a trusted primary care doctor on the medication side allows for a positive, collaborative approach.
How Can My Primary Care Physician Support My Mental Health?
Navigating mental health services can be daunting, especially when you have symptoms of depression or anxiety. Access is essential, and making that first call can be a significant hurdle. Many patients are most comfortable starting with their trusted primary care doctor. Your physician can screen you for symptoms and make a plan, including helping you find a counselor and prescribing medications as needed. Your doctor can also support your mental health with lifestyle changes, including diet, exercise and managing chronic conditions. Quitting smoking and eliminating or moderating alcohol use can also boost mental health. Dr. Ojha and the Norvinia Health team see supporting patients with depression and other mental health challenges as an integral part of overall wellness. “Our office is an excellent first call if you have concerns and don’t know where to begin,” says Dr. Ojha.