People Often Don’t Tell Their Doctor About Being Depressed

Fourteen million Americans are depressed, according to recent estimates.  Half of them will get treatment, and only half of these will be adequately treated.  This suggests a communication gap between the patient and her/his family physician.  University of California, Davis, have tried to assess peoples’ reasons for not disclosing depression to their family doctor, and have published their findings in the Annals of Family Medicine.

The scientists surveyed over 1,000 Californian residents by phone.  The participants were asked about reasons for nondisclosure of depressive symptoms to their doctor, their views and beliefs about depression, along with some demographic information.

Of those willing to respond, 43% gave one or more reasons for non-disclosure.  The most frequent reason was anxiety that the doctor would recommend an antidepressant (23% gave this reason).  Other reasons varied, depending whether the individual had a history of depression.  Thus people with a history of depression were worried about privacy and losing emotional control.  Those without a history of depression were more likely to feel their family physician was not the right sort of doctor to consult, but they also worried about going to a psychiatrist or being treated with antidepressant medications.  It was encouraging that 7 of 8 subjects said they felt primary care physicians were capable of diagnosing and treating depression.

A feature of the results was an apparent fear of antidepressants.  It may well be that the direct-to-consumer advertising on TV help to increase this fear.  The FDA expects the adverse effects to be ‘given equal time’ in ads, and this may be sufficient to turn potential patients away.  I can only urge people with symptoms suggestive of depression – fatigue, difficult concentrating, feelings of guilt, hopelessness, sleep problems, even thoughts of suicide – to consult with their family physician.  He/she will be able to decide if referral to a psychiatrist would be helpful, or indeed necessary. The vast majority of patients with depression cam be helped to recover their normal place in society.