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Zorba Paster: It’s Time To Talk About Depression

A Recent Study Showed Many Clinicians Are Not Taking Action On Depression

Vinay Shivakumar (CC-BY)

If you had pneumonia, you’d take an antibiotic, right?

If you had a broken wrist, you’d get a cast or have surgery, right?

If you had crushing chest pain that took your breath away, you’d call 911, right?

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So I ask you why is it that if you have depression that is ruining your life, you don’t take action?

Studies show that one out of 20 people have depression at one time or another. And it’s awful.

Yet according to new research, we are vastly undertreating depression. Not only are patients not seeking help, clinicians aren’t taking action either.

The U.S. Preventive Services Task Force recommended in January that health professionals screen for depression regularly with a simple nine question form. (Google PHQ9 and you can take the questionnaire yourself.) Do doctors do this? Well… Some of us do, some of the time.

But, frankly, if you’re coming in with three things to discuss with me — how much time do I have to look at the questionnaire?

Here’s where the electronic medical record would be most helpful. If you could take the PHQ9 by yourself and have the results on the chart when you came in to talk to your doctor, then that might result in a meaningful conversation about therapy. At least it would be a start.

But there is one more fly in the ointment here. A recent study showed that even with the results of the questionnaire showing depression, many clinicians are not taking action. They are not offering patients therapy. So why is this?

The study doesn’t answer that, but I have my thoughts. Too much stuff to do at the visit. The average patient might call with one question but when they’re there they have three questions. (We docs call it the but one more thing.)

It’s part of the patient visit to try to get everything wrapped up but that also means there’s no time to discuss the depression issue unless you — the patient — brings it up.

This is one reason that it’s so important for you to bring in a list of things you want to discuss with your clinician when you’re at that visit. It helps you formulate what you want in a timely way so that you get the care you want and we stay on time. In the hurly-burly world of medicine you don’t have an hour with your doc — you have much less time. But as with so many things in life, you can make the most of it by planning in advance.

My spin: You’re in the driver’s seat here. Take the PHQ9 yourself; and armed with that go see your doctor and discuss it. There are very effective treatments with medication, talk therapy or both that can put you on the right track. Depression is a risk factor for heart attacks and stroke. It can ruin your quality of life and it just plain stinks.