Why Your Primary Care Physician May Not Be Your Best Choice For Depression Treatment

14 March 2016
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Depression is a complicated disease that needs a multi-faceted approach to treatment. A 2016 study published in "Health Affairs"  shows that primary care physicians often fall short in proper treatment of depressed patients.

Why People Choose Primary Care Doctors to Treat Depression

For some patients, access to mental health professionals may be limited, especially in remote or rural areas. The specialists they find may not accept their insurance. A large part, though, is that patients feel stigmatized and embarrassed about having to see a psychiatrist, and they are more comfortable with their regular doctor.

How Medical Professionals Fail in Depression Treatment

Physicians want to treat conditions such as anxiety and depression as a physical illness, but these conditions are much more complicated. The study found that doctors often do not use the same standard of care for depression that they do for other chronic illnesses, such as heart disease or diabetes. When it comes to "best practices" for treating chronic depression, physicians simply did not follow proper protocol.

The Five-Step Protocol for Chronic Illness

When dealing with a chronic illness, there are five steps that should be followed:

  • Employing nurse care managers
  • Keeping a registry of patients and performing regular follow-ups
  • Reminding patients to stay on their treatment program
  • Teaching patients about their illness
  • Giving doctors feedback

Only about one-third of the practices surveyed kept registries, while less than 10 percent followed steps four and five. However, doctors were much more likely to use best practices with other chronic illnesses, such as diabetes.

Depression's Affect on Overall Health

Chronic depression has been found to contribute to a number of other diseases, such as pulmonary disease or heart disease. When not treated properly, it can cause problems on the job, interfere with relationships, and, in the extreme, lead to suicide. When proper tools are used for treatment, patients practice better self-care, so they are healthier and more productive.

Why Doctors Fail at Treating Depression

First, time is a deterrent to proper care. Depression can't really be treated in a 15-minute doctor visit. Another reason is that doctors struggle to know how to treat issues that can't be cleared up with medication. There are no definitive tests for the level of treatment needed like there are for diseases such as high blood pressure. Real communication and follow-up is essential to monitor and adjust medication dosages. More importantly, most physicians aren't trained in counseling, which is a vital part of mental health treatment.

Your primary care physician may mean well, but they aren't the best person to treat your chronic depression. You need to find a qualified psychiatrist who will follow up on your treatment properly and also be able to give you necessary counseling. For more information, contact a counseling center like The Center for Family Counseling, Inc.