Depression: What To Do If Your Doctor Wont Help
I dont know what to do my doctor wont help me! I was calling my boyfriend from the basement at work, needing some privacy to talk about my mental health. Id just been told there was a two-year waiting list for the help I needed.
That morning, Id phoned my doctors surgery for an update on when I might be assessed by a psychiatrist. Id had to explain everything to the receptionist, then wait for my doctor to call me back.
She phoned an hour later and told me to call the clinic Id been referred to. This surprised me because I hadnt been given the clinics name before, or told that patients could contact them directly. By now, Id been waiting four months for an update. I was frustrated that the referral process hadnt been explained at my first appointment.
When I phoned the clinic, they had no records of me being referred there.
My doctor wasnt available to talk when I called her back. I had to go over everything again with a different receptionist, who gave me the number of a second clinic. Five minutes later, I was talking to another stranger about my mental health.
The latest voice on the phone sounded distracted and emotionally disengaged. She told me that Id need a new referral from my doctor. The expected wait time was at least a year, but more likely two.
Do I Have To Tell My Doctor Im Not Okay
If you are on a low budget here in the UK, and want to access free mental health support through the NHS? You do need to go through your GP to get a referral. Mental health services are by referral only.
If for one reason or another you simply cant bring yourself to tell your GP you are struggling mentally and emotionally? There are other ways to find help. Please read our article on how to find free or low cost counselling for ideas.
Tip #: Take Ownership Of The Follow
Ideally, when a new diagnosis is made and a psychiatric medication is prescribed, a follow-up call or visit should be scheduled within one to two weeks. At this early stage in treatment, the doctor can confirm that the patient is taking the medication correctly, and assess whether he or she is seeing any improvement in symptoms or experiencing any side effects. But as recent studies of electronic medical records from across the nation reveal, doctors often schedule the first follow up appointment a month or more after the initial consult, missing the opportunity to intervene early in treatment.
Timely follow-up is important to keeping you and your doctor on the same page. If your doctor doesnt schedule a follow-up appointment shortly after you begin treatment, you need to do so. While it is asking a great deal of a patient to be proactive, especially when he or she is feeling down and vulnerable, the best outcomes result when patients play an active role in their treatment. Youve already shown courage by sharing your concerns build on that victory by continuing to own your diagnosis and treatment plan.
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Tip #: Recognize That Although You May Feel Uncomfortable You Are Sharing A Legitimate Medical Concern In Order To Get The Help You Need
Too often, patients are afraid of bringing up their mental health concerns. Sadly, despite great progress in the field, mental illness is still a subject branded by shame, misunderstanding and stigma. If you associate your symptoms with weakness or character flaws, its no wonder you hesitate to discuss them. Thats why the very first conversation you need to have is with yourself. Depression is a serious illness, with specific medical strategies for managing it. Read more about countering stigma, including your own, here.
Im Really Sorry Youre Going Through This Im Here For You If You Need Me
The fact is, theres no perfect thing to say to someone living with depression. Your words wont cure them. But they can help.
Reminding someone that youre there for them whenever they need you whether thats in the form of help with a small task or someone to call in a crisis can be so essential to saving a life.
According to the American Foundation for Suicide Prevention, there are three categories of suicide warning signs to look out for:
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How Can I Take Care Of Myself
Once you begin treatment, you should gradually start to feel better. Go easy on yourself during this time. Try to do things you used to enjoy. Even if you dont feel like doing them, they can improve your mood. Other things that may help:
- Try to get some physical activity. Just 30 minutes a day of walking can boost mood.
- Try to maintain a regular bedtime and wake-up time.
- Eat regular, healthy meals.
- Do what you can as you can. Decide what must get done and what can wait.
- Try to connect with other people, and talk with people you trust about how you are feeling.
- Postpone important life decisions until you feel better.
- Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.
You Feel Sad Empty Or Hopeless Most Of The Time
Your emotional life changes significantly when you have depression. Typical symptoms include the inability to anticipate happiness or pleasure, and an overarching feeling of emptiness.
However, irritability or increased anger can also be signs of depression. Your self-esteem might be low, too, with feelings of worthlessness or misplaced guilt creeping into your everyday life.
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Questions Doctors Ask When Screening For Depression
Mental health professionals rely on a number of screening tools to accurately diagnose depression. Here’s a peek at the questions they ask so you can assess your own risk.
Not everyone experiences the same warning signs of depression. Some people may endure sadness, hopelessness, feelings of guilt others may lose interest in their favorite activities, have trouble thinking clearly, or face fatigue and changes in their sleeping or eating patterns. Thats why diagnosing depression isnt always easy and why doctors have developed a number of screening tools to help determine if you are at risk.
“Diagnosing depression requires a complete history and physical exam, says Richard Shadick, PhD, associate adjunct professor of psychology and director of the counseling center at Pace University in New York City. Doctors must also rule out medical problems such as thyroid disease and consider coexisting emotional health issues like anxiety disorder, post traumatic stress, and substance abuse.
What goes into a depression screening? “There are many types of depression scales and depression screens, explains Shadick. The questions asked look for common symptoms as well as how much these symptoms might be affecting a person’s ability to function and maintain relationships.”
Which Depression Screening Will Your Doctor Use?
The Type of Questions Your Doctor Will Ask
Here are some typical questions from a few of the more common depression screening scales:
Tip #1: Make Sure Your Providers Are Communicating With Each Other
Just as you may need to take the lead in coordinating your follow-up, you may need to take steps to keep everyone participating in your care connected. It is common for the PCP to prescribe medications while therapy is provided by a psychologist, social worker or other specialist. To help facilitate communication between your providers, first make sure that you have signed a release form so that your physician and therapist can exchange information while protecting your privacy. It is also helpful to have your therapist share his/her diagnostic assessment along with notes about the objectives of your therapy with your doctor.
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Stage An Intervention If Necessary
Often, people with depression are unwilling or unable to recognize that theres a serious problem. At such times, it may be necessary to stage an intervention. Again, its crucial to seek help from close friends or family members. Explain the situation to them. Then schedule a time when everyone can get together to express your collective concerns.
Keep in mind that you should approach your loved one gently. Use compassion and understanding, not judgment. Offer to lend support, but remain insistent that they take steps to address the problem.
If you think someone is at immediate risk of self-harm or hurting another person:
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but dont judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
How To Talk To Someone About Depression
Sometimes it is hard to know what to say when speaking to someone about depression. You might fear that if you bring up your worries the person will get angry, feel insulted, or ignore your concerns. You may be unsure what questions to ask or how to be supportive.
If you dont know where to start, the following suggestions may help. But remember that being a compassionate listener is much more important than giving advice. You dont have to try to fix your friend or family member you just have to be a good listener. Often, the simple act of talking face to face can be an enormous help to someone suffering from depression. Encourage the depressed person to talk about their feelings, and be willing to listen without judgment.
Dont expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. You may need to express your concern and willingness to listen over and over again. Be gentle, yet persistent.
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How Can I Help A Loved One Who Is Depressed
If someone you know has depression, help them see a health care provider or mental health professional. You also can:
- Offer support, understanding, patience, and encouragement.
- Invite them out for walks, outings, and other activities.
- Help them stick to their treatment plan, such as setting reminders to take prescribed medications.
- Make sure they have transportation to therapy appointments.
- Remind them that, with time and treatment, the depression will lift.
Take comments about suicide seriously, and report them to your loved ones health care provider or therapist. If they are in immediate distress or thinking about hurting themselves, call 911 for emergency services or go to the nearest hospital emergency room.
Selective Serotonin Reuptake Inhibitors
If a GP thinks you’d benefit from taking an antidepressant, you’ll usually be prescribed a modern type called a selective serotonin reuptake inhibitor .
They help increase the level of a natural chemical in your brain called serotonin, which is thought to be a “good mood” chemical.
SSRIs work just as well as older antidepressants and have fewer side effects, although they can cause nausea, headaches, a dry mouth and problems having sex. But these side effects usually improve over time.
Some SSRIs are not suitable for children and young people under 18 years of age. Research shows that the risk of self-harm and suicidal behaviour may increase if they’re taken by under-18s.
Fluoxetine is the only SSRI that can be prescribed for under-18s and, even then, only when a specialist has given the go-ahead.
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Choosing The Right Doctor
The first thing you will want to do is to make sure that you are choosing the right doctor with whom to speak. While it might make sense to make an appointment with your family doctor or general practitioner, this might not always be the case.
If you do not see this doctor often or feel embarrassed to talk to this doctor, but there is another doctor whom you do see often , it might make more sense to bring it up during one of your regular appointments with them. If for some reason you end up going to the emergency department, then the ER doctor there will be able to help you.
If none of these seem to be an option, you could also consider going directly to a mental health professional however, you will likely need to work backwards and get a referral from your doctor at that point.
Mental health professionals to approach would include a social worker, counselor, psychologist, psychotherapist, registered nurse, or psychiatrist. You might find these professionals working in private practice or through a community health center, outpatient mental health clinic, employee assistance program, or family/social services agency.
Maybe I Am Beyond Help
If they brush you off, dont listen, or in any way belittle you? You have the right to see another doctor. It can feel really overwhelming if we are already depressed and anxious and having to deal with this. Our first instinct can be to go home, cry, and assume we are beyond help or that we are hopeless.
You are not. Doctors are people and are not perfect. And while some are wonderful, some are not. Like all professions, you get varying levels of competence. If you dont have the courage to call up and ask to see someone else, see if a friend or partner can call for you. Ask if there is a doctor available who specialises in mental health in case that is an option.
Still have a question about how to talk to your doctor about anxiety and depression? Post below.
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Make An Appointment Asap
Start by talking with your primary care provider. Many health conditions can cause mental health symptoms. Your provider can do a full physical exam to see if your symptoms have an underlying cause. He or she may refer you to a mental health professional, such as a psychiatrist.
When you make an appointment to discuss mental health, tell the person on the phone why youre calling. For example, you could say you think you might have depression and would like to get help. This will allow him or her to book enough time at your visit for you and your healthcare provider to discuss your concerns.
If youre really struggling, you may feel like you need to talk with someone as soon as you can. If you cant get in to see a provider as soon as youd like, ask to be added to the cancellations waiting list. If someone cancels, you might be able to squeeze in a last-minute appointment.
In an emergency situation, such as when you are thinking of harming yourself, go to the emergency room immediately.
Does Depression Look The Same In Everyone
Depression can affect people differently, depending on their age.
Children with depression may be anxious, cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die.
Older children and teens with depression may get into trouble at school, sulk, be easily frustrated feel restless, or have low self-esteem. They also may have other disorders, such as anxiety and eating disorders, attention-deficit hyperactivity disorder, or substance use disorder. Older children and teens are more likely to experience excessive sleepiness and increased appetite . In adolescence, females begin to experience depression more often than males, likely due to the biological, life cycle, and hormonal factors unique to women.
Younger adults with depression are more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalized anxiety disorder, social phobia, panic disorder, and substance use disorders.
Middle-aged adults with depression may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning awakening. They also may more frequently report having gastrointestinal symptoms such as diarrhea or constipation.
What Your Gp Can Help You With
If you speak to your GP about your mental health concerns, they can:
ask questions about your feelings and thoughts that may help you better understand what you are going through and what support is available
offer your medication if it’s appropriate and/or free talking therapies
recommend simple lifestyle changes that can improve your mental health
invite you back for another appointment in a few weeks’ time to see how you’re doing. They may refer you to a specialist if they think that would be more helpful.
If you feel very worried about your mental health or are considering taking your own life, you should talk to someone. You can call your GP surgery and arrange to speak to someone immediately, or alternatively the Samaritans offer completely confidential emotional support 24 hours per day:
Considerations And Precautions Of Benzodiazepines For Anxiety
Benzodiazepines have potential for abuse and addiction. In some cases they can actually make anxiety and depression worse.
Benzodiazepines work by slowing down the nervous system both mentally and physically. This can have unwanted side effects as motor and cognitive skills are impaired.
Taking these medications with other prescription and recreational drugs can be life threatening and lead to death.
Overdose is possible.
Talk to a doctor about your mental and physical health, as well as your medical history and symptoms to see if this class of medication is right for you.
Tip #: State Your Concerns As Plainly As You Can
If you describe your symptoms too vaguely, the doctor may look for physical causes, rather than honing in on emotional factors. Instead, use clear statements like I think I might be depressed, or I am experiencing the following symptoms to begin the conversation. The more direct and specific you can be, the easier it will be for your doctor to respond effectively.