Improve Communication With Your Primary Care Physician About Depression

The National Depressive and Manic-Depressive Association (National DMDA) learned in a new survey that consistent and open communication about treatment for depression and antidepressant side effects does not occur often enough -- or thoroughly enough -- between patients and their primary care doctors.  This news is troubling, since the survey also showed that people with depression rely chiefly on their primary care doctors for treatment of their illness.  This communication gap can result in problems with troublesome and unaddressed side effects, lack of compliance with antidepressant therapy and sub optimal recovery for people suffering from major depression.

To help patients achieve the best recovery possible, and to strengthen the patient/doctor relationship, both parties need to learn to communicate more effectively about the treatment of depression and about the side effects of antidepressants. The National DMDA offers the following advice to get patients started:

1. Make a list of what you want to discuss with your doctor and take notes.  Before each visit to your doctor, write down questions regarding treatment for your depression, especially any issues about side effects.  Refer to the list during your appointment so you can remember each issue you want to cover.  In addition, since your doctor will probably cover a lot of information in a short period of time, write down the doctor's recommendations and instructions -- and read it out loud at the end of the appointment to confirm what you have heard.  These notes will help you recall what to look out for and what to do between appointments.  Make sure to follow up with a phone call if you have additional questions after your appointment.  If the doctor is not available to talk to you, ask for the nurse who may be able to answer some of your questions.
   
   
2. Ask about side effects.  If you are already taking an antidepressant or if your doctor prescribes a new one or a greater dose, ask about all possible side effects.  Also, do your homework - research antidepressant side effects on the National DMDA's website (www.ndmda.org), at the library, or ask your pharmacist.  If your antidepressant side effects are bothersome, persistent, or if your depression is less than completely controlled, you may have other treatment options.  Let your doctor know about your concerns and keep working together to choose a treatment plan that is acceptable to both of you.  Be clear about your expectations and desires, including side effects.  Do not skip doses or stop taking your antidepressant without talking to your doctor first!
   
   
3. Work with your doctor to identify "hidden" side effects you might experience.  It can be difficult to distinguish certain side effects of antidepressant medication from symptoms of depression itself.  For example, weight gain and sexual problems can be caused by either the disease or by antidepressants.  Pay close attention to areas where you expected to see improvements that have not occurred, or physical changes that you may not understand.   Raise these issues with your doctor - by phone or in person - and ask if they could be a side effect from your antidepressant. 
   
   
4. Discuss the most important or most difficult question(s) first.  Make sure your doctor understands the importance of your concerns by bringing up your most pressing issues at the beginning of your appointment.  Don't move on to discuss another subject until your questions have been answered.  Discussing your key concerns early will give you a chance to digest the information during your examination, and will give you time to ask any additional questions you might think of before your appointment is over.
   
   
5. Help your doctor make time for you.  If you need more than 10 minutes to discuss your progress or concerns at your next doctor's appointment, let the doctor's office know in advance.  Ask specifically for an appointment when the doctor is less rushed.  If possible, let your doctor know beforehand what you want to talk about.  Also, if you have a number of questions or if you want to discuss a subject that may be awkward, such as sexual problems, request to begin your appointment in the doctor's office rather than the exam room.  You will feel more comfortable and in control if you are dressed and sitting eye-to-eye with your doctor - instead of wearing a hospital gown in the exam room.

Founded in 1986, the National DMDA is the nation's largest patient-directed, illness-specific organization with more than 400 support groups across the United States and Canada. Its mission is to educate patients, family members, professionals and the public that mood disorders are treatable medical illnesses.

For more information on depression on DrDonnica.com, click here.

For more information from the National DMDA, click here.

Click here for more information about depression or other mental health issues.

Click here to see Dr. Donnica discussing depression in or after pregnancy on ABC's "Good Morning America Health".

Created: 2/14/2001  -  Donnica Moore, M.D.