Depression is so insidious and pervasive.  When I see a patient for the first time I ask about their medical history: lung and heart problems, seizures, kidney disease AND anxiety and depression. It is that common. . . and that important to treat. Depression seems to zap the joy of life.

I question the patient about

• thoughts of self-harm or hurting others,
• if they have a plan,
• if they’ve had treatment before (was it effective? Why did they stop?).

There are resources: counseling, focus groups, psychotherapy, and pharmacotherapy (drugs). Most medication takes 6-7 weeks to start working. Family may see a benefit before the patient does. The patient should commit to 6 to 9 months of medication, to decrease the risk of relapse. Exercise and other positive lifestyle changes should be encouraged.

 Anti-depressant medications often help greatly. Many formulations also help with anxiety. Frequently patients want to discontinue the anti-depressants as soon as they feel “normal” again. I convince them to stay on the medication. If they insist on weaning I ask them to tell a loved one what they are doing. So that if depressive behaviors resurface, the patient can resume full-dose medication.

My goal for my patient is for them to lead the life they were meant to lead. Depression gets in the way of that. Frequent visits, with a plan geared toward the patient’s needs, works best!

I hope this helps.