How to Tell Your Doctor You're Depressed

If you haven't been feeling like yourself and think you might be depressed, speak with your family doctor first if you have one. If you don't have one, then scheduling an appointment with a general practitioner would be a good place to start. The reason for this recommendation is that there are several medical conditions, such as vitamin and mineral deficiencies, hormonal changes, and thyroid conditions that can cause symptoms similar to depression. It's also possible that your depressed feelings could be the result of medication side effects or some other cause.

By giving you a thorough checkup, your doctor can rule out any other potential causes of your depression symptoms. In addition, depending upon how your insurance works, it may be necessary to see your primary physician first in order to obtain a referral to a more specialized mental health care provider, such as a psychiatrist or psychologist.

While you may feel embarrassed to ask for help, it is not necessary to feel this way. Depression is a very common condition and your doctor is already quite familiar with it. It will not seem strange or shameful in any way to your doctor that you are feeling depressed.

In addition, you don't need to worry about your friends, family, or employer finding out about your depression. The HIPAA (Health Insurance Portability and Accountability Act) Privacy Rule prevents your physician from disclosing your private medical information without your permission.

Unfortunately, there isn't currently a definitive lab test that can be used to diagnose depression so your doctor will do a few things. First, your doctor will perform a physical exam and run several different blood tests to rule out other conditions that might be causing your symptoms. Some of the possible tests might include:

• Complete blood count (CBC)
• Thyroid function check
• Creatinine and blood urea nitrogen (BUN)
• Liver function check
• Fasting blood glucose
• Cholesterol
• Calcium and magnesium level

Next, your doctor may ask you some questions to determine whether you have any possible risk factors for depression. Some of the known risk factors for depression include:

• Being female
• Being under stress
• Undergoing adverse events during childhood
• Having certain personality traits
• Having a family history of depression
• Not having many friends or personal relationships
• Having recently given birth
• Having a history of depression
• Having a serious illness
• Taking certain prescription medications
• Drug or alcohol use

In addition, your doctor may ask you about what symptoms you are experiencing. Among the symptoms they might ask you about are:

• Feelings of sadness or depression
• Not enjoying things like you used to
• Changes in appetite or weight
• Insomnia or sleeping more than usual
• Feeling restless
• Feeling extremely tired
• Feeling hopeless
• Feeling worthless
• Feeling helpless
• Feeling guilty
• Having problems thinking, concentrating, or making decisions
• Thinking frequently about death or suicide

Your doctor will supplement all of the information that you provide with their own observations of your behavior. People with depression often exhibit the following signs:

• Appearing preoccupied
• Avoiding eye contact
• Not remembering things or appearing to have trouble concentrating
• Pacing, wringing their hands, or pulling at their hair
• Appearing agitated
• Speaking slowly with long pauses
• Sighing
• Moving slowly
• Being self-deprecating
• Crying or appearing sad

If your doctor has ruled out other possible causes for how you are feeling and feels that your symptoms and history are indicative of depression, they will either opt to treat you using antidepressant medications or they may instead refer you to a mental health professional such as a psychiatrist or psychotherapist (or both).

Psychiatrists have specialized training and expertise with using medications to treat depression and mental illness while psychotherapists specialize in using talk therapy to help you with your depression. A combination of the two approaches is often the best way to treat depression.

There are a number of different types of psychotherapy that can be effective in the treatment of depression.

Cognitive behavior therapy (CBT) is a short-term approach (often between 5 and 15 sessions) that focuses on identifying negative thought patterns, replacing them with more helpful ones, and learning new coping strategies.

Interpersonal therapy (IPT) is short-term like CBT and focuses on identifying problems in relationships and then improving how people relate and communicate with others. 

Your doctor or psychiatrist may also prescribe some type of medication to treat your depression. Some of the different types of antidepressants that your doctor or psychiatrist may prescribe include:

• Selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine) and Zoloft (sertraline), which act to increase the amount of serotonin in the brain.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Effexor (venlafaxine) and Cymbalta (duloxetine), which increase the amount of serotonin and norepinephrine in the brain.
• Tricyclic antidepressants (TCAs) such as Norpramin (desipramine) and Elavil (amitriptyline) are a type of older medication that, while not often used as a first-choice treatment, may be helpful when other types of antidepressants have not been effective. 

Self-care is an important part of depression treatment, and there are a number of things that you can do that will complement your other treatments. 

Get plenty of sleep. Research has found that there is a complex relationship between sleep and depression. Sleep disturbances are common symptoms of depression, and studies suggest that there may be a reciprocal relationship between them. Poor sleep increases the risk of depression, and depression then leads to an increased risk of reduced sleep quality.

Exercise regularly. Research suggests that regular physical activity can be effective in the treatment of mild to moderate depression. In more moderate to severe cases, exercise can be a beneficial complement to medication and therapy.

Eat a healthy diet. While researchers are still working to understand the link between diet and depression, there is little doubt that eating well can improve health and well-being. One 2017 study found symptoms of depression decreased when people had nutritional counseling and following a healthier diet for 12 weeks. There is no specific diet to relieve depression symptoms, but focusing on a varied diet that includes whole fresh foods and plenty of fruits and vegetables is a good place to start. 

Complementary medicine may also have beneficial effects on well-being when used in conjunction with psychotherapy and medication. Acupuncture, meditation, light therapy, and herbal supplements are some alternative options that you might consider.

While it might feel difficult at first to talk to your doctor about your feelings of depression, having this discussion is an important first step toward improving your well-being. Tell your doctor that you have been feeling down and that you suspect you might be depressed. Your doctor can then rule out or treat any underlying medical conditions that might be contributing to your symptoms and recommend appropriate treatments. Starting this conversation can help you get the help and support that you need to start feeling better.