Depression | The importance of recognition and treatment in primary care.

Patients are often surprised when I ask about their mood. There is no hesitation when I inquire about their blood pressure, glucose levels or if they are taking their medications regularly. On the other hand, there is always a brief pause before I get a response when asking about mood. I can see many fleeting things running through their mind such as family life, financials, goals, disappointments…and when they are all summed up, and a list has been made. Some patients choose to ignore their overwhelming list and say that their mood is great! Some then realize that they have been going through life in a state of depression. The reality is we are not talking about depression enough. According to the U.S. Preventive Services Task Force and The American Academy of Family Physicians, all adult patients, and all postpartum women should be screened for depression. Children and Adolescents twelve and eighteen years of age should be screened as well. Major depression is one of the most common mental health disorders in the United States and failure to recognize symptoms can be deadly.

Here at Bear Fruit Direct Primary Care, I want my patients to understand that I am equally concerned about their mental health as I am about their physical health. Mental Health is directly related to Physical Health and this concept should be viewed as one. Depression is when there are low chemicals in the brain that causes a certain chemical imbalance. Some people have more risk of having this imbalance than others because of their genetic makeup. There are also many other factors that contribute to developing depression such as environment, upbringing, and individual circumstances. Major Depression is one of the most common health disorders in the United States, so why aren’t we talking about it?

Some may feel that depression means mental weakness and they need to simply, “handle it” or, “grin and bear it.” Unfortunately, the dangers of not recognizing and treating this disease can have detrimental effects on the body, families, employment, and education. Depression does not equal a weak mind. I’ve even had some patients go as far as thinking that they are, “crazy” when discussing symptoms of depression. Some are despondent and not sure how to cope or make sense of what’s going on. They question their integrity as a human being as if their depression dictates to who they are and how

“good” they are. But depression is simply having a chemical imbalance in your brain. We don’t question one’s integrity when they have autoantibodies that lead to thyroid disease or arthritis. We don’t think less of people when they can’t make the insulin that results in diabetes. So why do we have this misconception with depression? Having a chemical imbalance that causes certain symptoms will need treatment just like any other disease.

Some indications that you may have depression are decreased interest in activities, energy, concentration or sleep. Feelings of guilt, worthlessness and or hopelessness are also symptoms of depression. Even appetite can be affected, whether it has increased or decreased. Depression may not look the same in everyone. Men, women, and children may all have different symptoms but your primary care physician can use screening methods and tools to help make the diagnosis.

In primary care, we like to practice preventative medicine and assess risk. This means that we want to have regularly scheduled oil changes before the motor goes out! We do this by assessing risk factors. Some risk factors that may lead to depression are a history of anxiety, substance abuse, childhood abuse, chronic medical conditions, disturbed family environment, history of divorce or separation, parental loss or uncontrolled pain. Every patient should know, that there are many other conditions that can mimic depression. It is imperative that you see your primary care physician for a complete history and physical so that the correct diagnosis is made.

Start the conversation today with your primary care doctor if you or a family member are concerned about depression. You should not feel ashamed or embarrassed if you show signs of depression. It is important to view your mental health as your overall health because one directly correlates with the other. Keep in mind that there are various forms of treatment for depression and everyone is different. your primary care physician may use different ways to diagnose or treat you. It’s most important that your doctor takes time for a complete assessment, that is non-rushed or hurried, and that they make you feel comfortable. Make sure you and your family members are being screened for depression because failure to do this can lead to hospitalizations and even death. Lastly, do not think that you are crazy, less than, or different if you are struggling with depression, it’s simply a chemical imbalance and we need to talk about it. Many Primary care doctors in Little Rock are accustomed to dealing with the treatment of depression. When looking for a great family practice or medical clinic, be sure to give our office a call and schedule your visit today!