Real stories by real family physicians
When a patient is diagnosed with depression, I’m trained to provide care ranging from prescribing antidepressants to helping find other resources.
Depression is a medical illness that affects people of all ages. It can make it hard for people to take care of themselves or function at work or school. It can even be dangerous, leading to self-harm or thoughts of suicide. Fortunately, depression is treatable. As a family doctor, I’m trained to care for patients who have depression and help them find useful resources and support.
Recently, a 19-year-old woman named Megan (not her real name) came into my office for a visit. She had been feeling sad and down throughout the past year. The problem wasn’t just feeling “a little blue” sometimes. Megan hadn’t been eating well and had lost weight. Things she used to enjoy, like going to movies with friends and playing volleyball, didn’t seem interesting anymore. She was having trouble paying attention in class, and she just couldn’t get motivated to do her homework. As a result, her grades had dropped.
My nurse asked Megan to fill out a simple questionnaire that helps identify whether a person may have depression. Megan’s high score on this questionnaire indicated a possible diagnosis of depression. After looking at her responses, I talked with her. Megan told me she felt a little embarrassed to be admitting out loud that she was struggling. Like many people, she had a hard time explaining exactly what she was feeling. She took several long pauses, but I was careful not to interrupt.
Megan told me that she was feeling both sad and anxious at the same time. “I feel like I’m coming out of my skin,” she said. Although she felt tired all the time, she couldn’t fall asleep at night. She would often toss and turn for hours, usually thinking about past mistakes. Sometimes, she wished she could just disappear. Fortunately, she had not thought about hurting or killing herself.
As Megan talked, I noticed her body language and speech patterns. She fidgeted with her hands a lot, and she looked mostly at the floor. I asked some questions to make sure she was safe and to rule out other things that can make depression worse. Megan said that she was not using drugs or alcohol or engaging in high-risk sexual practices. She said that she felt safe at home and elsewhere, but she wasn’t comfortable talking about her feelings with her parents. I thanked her for having the courage to come in and ask for help. She admitted it had been hard for her.
I let Megan know that it’s common for depression and anxiety to go hand in hand. I explained that they don’t just cause psychological symptoms. They can also affect you physically and cause symptoms like chest tightness, fatigue, headaches, and jitteriness. Since I could tell that Megan held a lot of her feelings in her body, I recommended taking a few minutes each day to put on music and dance. Dancing is a great activity to help relieve tension and improve your mood. I also taught Megan a relaxation technique to use whenever she was feeling anxious. It’s a simple, effective exercise called soft-belly breathing. It involves breathing slowly in through your nose and feeling your belly fill with air before breathing out through your mouth.
In addition to counseling, I prescribed a low dose of an antidepressant for Megan. (Learn more about antidepressants and how to take them safely.) I explained to Megan that it can take several weeks for an antidepressant to start working. Side effects from these medicines usually decrease after a couple of weeks.
When a person starts taking medicine to treat depression, there is a risk of increased suicidal thoughts, particularly in young people. Although this is rare, I discussed the risk with Megan and made sure she had a plan, just in case. She already knew about suicide hotlines that are accessible by phone, text, or online (for example, the National Suicide Prevention Lifeline at 1-800-273-8255). She also identified a friend to call if she had thoughts about hurting herself. I assured her that she could always call her counselor or my office, or go to an emergency room if she needed help right away.
I asked Megan to come back for a follow-up visit in 1 week so I could see how she was tolerating the antidepressant. She told me it was a relief to talk about her feelings. She felt hopeful that her symptoms would improve over time. As Megan’s family doctor, I’ll continue to guide her treatment for depression and provide needed care and support.
Reach Out for Help
People who have depression sometimes think about suicide. If you have thoughts about hurting yourself, tell someone. Tell your doctor, your friends, or your family. You can also call a suicide hotline, such as the National Suicide Prevention Lifeline at 1-800-273-8255.
Get help right away. There are people who can help you. Depression can be successfully treated.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.