May is Mental Health Month and an excellent time to educate ourselves on the various aspects of the disease. Many of us are not aware of the impact mental health can have on physical health and vice versa. Although there are several forms of mental illness, ranging from schizophrenia to bipolar affective disorder, one of the most common is depression. Depression can appear in many forms and can be brought on by triggers, such as after the birth of a child (postpartum), physical ailments, conditions or life events and situations. Therefore, it is important to know that there are a variety of treatments and services available to you.
The Journal of the American Medical Association (JAMA)1 contains recommendations from the US Preventive Services Task Force (USPSTF) for screening, treatments and services, as well as prevention for depression in adults.
To ensure accurate diagnosis, effective treatment and follow-up, screening should occur in a clinical setting. There are several commonly used screenings by providers including the Patient Health Questionnaire (PHQ) in various forms, the Hospital Anxiety and Depression Scales in adults, the Geriatric Depression Scale in older adults and the Edinburgh Postnatal Depression Scale (EPDS) in postpartum and pregnant women. All positive screening results should lead to additional assessment that considers the severity of depression, comorbid psychological problems (e.g., anxiety, panic attacks or substance abuse), alternate diagnoses and medical conditions.
The Anxiety and Depression Association of America provides guidelines to help providers effectively diagnose and treat patients. Effective treatment of depression in adults may include antidepressants, specific psychotherapy approaches (such as cognitive behavior therapy (CBT) or brief psychosocial counseling)—which may be used alone or in combination.
CBT is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel. Therapy can be provided in individual sessions, group sessions or a combination.
If your provider prescribes an anti-depressant medication for you, be sure to tell them about any other prescription drugs and over-the-counter medications or supplements you are taking to avoid any negative side-effects.
Given the potential harms to the fetus and newborn child from certain pharmacologic agents, providers are encouraged to consider CBT or other evidence-based counseling interventions when managing depression in pregnant, postpartum or breastfeeding women.
Exercise can be hard to do when you are depressed but seems to have a positive impact on helping relieve depression and enhancing sense of well-being. Talk to your provider about what is most appropriate for your situation.
Both your primary care doctor and your mental health provider should know your entire treatment plan and coordinate their care together for your best interest and outcome. Be sure to take a list of your medications and treatment plan information with you to appointments as you discuss your care.
It is important to remember you are not alone. With the help of your health care provider(s), you can obtain the care you need to get your mental health back on track.
1 Albert L. Siu, M. M. (2016). Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement. Journal of the American Medical Association (JAMA), Volume 315, Number 4, 380-387. Retrieved from US Preventive Services Task Force.
2 Clinical Practice Review for Major Depressive Disorder. (2016, February 2). Retrieved from MDD Clinical Practice Review Task Force; Anxiety and Depression Association of America: https://www.adaa.org/resources-professionals/practice-guidelines-mdd