The discovery can be overwhelming or embarrassing, which may be why many people don't seek treatment. Here's how to navigate the road ahead.
When a medical condition is diagnosed, the next step for doctors and patients is usually pursuing treatment options—which could mean medication, surgery, or lifestyle changes, depending on the problem. But when that condition has to do with mental health, the path to recovery isn’t always so clear. According to a recent study in the Journal of General Internal Medicine, only about one-third of individuals newly diagnosed with depression seek out and actually start treatment.
For the new study, researchers at Kaiser Permanente reviewed medical records of more than 240,000 patients who received a diagnosis of depression in a primary care setting. Of those patients, only about 36% began taking antidepressant medication or seeing a therapist within 90 days of their diagnosis. Among those with severe depression, only about half started treatment.
There are many different reasons why a person might not seek out or follow through with treatment for depression, says lead author Beth Waitzfelder, PhD, an investigator with Kaiser Permanente Center for Health Research in Honolulu, including lack of resources, fear of social stigma, and doubts that a treatment can actually help.
But depression can be treated, she says, and thanks to a growing effort to screen for and recognize the disease in doctors' offices around the country, more people are being diagnosed. Which raises the question: What should you do after being told you have depression? We asked Waitzfelder to walk us through some very important steps for getting the help you need.
Take time to process your thoughts
For some people, a depression diagnosis at the doctor’s office comes out of the blue. “Most people are visiting their primary care doctor for some other unrelated reason; they have diabetes or cardiovascular disease or an injury of some sort,” says Waitzfelder. “Even if they suspect they might be depressed, they might be reluctant to acknowledge it or seek out a real diagnosis.”
In these cases, patients can be caught off-guard when a doctor brings up depression, says Waitzfelder, and some will shut down or tune out. But if you find yourself in this situation, know that you’re not alone: More than 16 million U.S. adults experience an episode of major depression each year, and it’s one of the country’s most costly and widespread health conditions.
Ask for a referral
If you’re diagnosed in a primary care setting, as the people in this study were, chances are your doctor doesn’t have a lot of time to discuss your treatment options with you. Yes, primary care doctors can prescribe antidepressants, says Waitzfelder—but if you want to truly understand your options, it can be extremely helpful to see someone who specializes in mental health.
“One of the things that many of our health-care systems are doing is locating a behavioral health specialist right in the primary care clinic, so when the patient gets a diagnosis, they can be immediately referred to this person,” says Waitzfelder.
Even if your doctor’s office doesn’t have an in-house specialist, she says, you should be able to get a recommendation for someone nearby. If you have health insurance, you can also search for in-network specialists on your plan’s website; if not, the Anxiety and Depression Association of America includes a list of resources on its website that offer assistance in paying for treatment.
Learn about treatment options
Most doctors consider there to be two main forms of treatment for depression: medications and psychotherapy, also known as talk therapy. These treatments may be pursued together or individually, and Waitzfelder says there’s no right or wrong answer as to which is “best.”
“There is evidence that outcomes are better when you make available the treatment that patient actually wants, as opposed to trying to force something they’re not interested in,” she says. “Some patients may not want medication and some patients may not want psychotherapy, so finding the right fit for you is very important.”
In the new study, more than 80% of those people who did start treatment opted for antidepressants rather than psychotherapy. Older patients and white patients were less likely to try psychotherapy compared to younger (18 to 29) people and racial and ethnic minorities. These differences in age and ethnic groups can be an important reminder that doctors should consider patient preferences when making recommendations and developing treatment strategies, the researchers say.
Don’t become a statistic
In the new Kaiser Permanente study, people who were Asian, Black, and Hispanic were 30% less likely to start depression treatment after a diagnosis than non-Hispanic white patients. And patients who were 60 or older at the time of diagnosis were only half as likely as patients under 44 to pursue next steps.
“Screening for depression in primary care is a positive step toward improving detection, treatment, and outcome for depression, but disparities persist,” says Waitzfelder. If you’re part of a group that’s at higher risk of not receiving treatment, it’s especially important to make sure you’re getting the attention and guidance you need.
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter
Open up to loved ones
Talking to family and friends can help, says Waitzfelder, along with seeking out trusted health-care professionals. Kaiser has even launched a public-awareness campaign, Find Your Words, to guide people in starting these difficult conversations.
“We have to try to break down the stigma that’s built around mental health and mental illness,” she says. “It’s probably the biggest barrier preventing patients from initiating treatment, which is why it’s so important to talk about depression in an honest and inspiring way.”