Who prescribed your antidepressant? Not a psychiatrist, most likely.
Up to 80% of antidepressants are prescribed by primary care doctors -- and given the high rate of clinical depression, "that's a good thing," says David Feinberg, MD, a clinical psychiatrist with the UCLA Neuropsychiatric Institute.
Like any medication, antidepressants can cause side effects. The specific problems vary from drug to drug -- and from person to person.
In fact, side effects are one of the main reasons that people with depression stop taking their medicine during their recovery. One study found that 65% of the 1,000 people surveyed said they had stopped taking their medicine, and half of those people cited side effects as the reason.
Yet it's important to keep in mind that antidepressants can help you recover...
In fact, many insurance plans require a primary care doctor be the first step in treatment. "Pediatricians, primary care doctors, and family doctors have always provided a tremendous amount of mental health care," Feinberg tells WebMD. "If they didn't, too much depression would not get treated."
However, the recent FDA warning about antidepressants -- that depression and suicidal thoughts could get worse at certain points in treatment -- concerns many people.
What kind of follow-up care should adults or children get from a primary care doctor? How frequently should they see their doctors? Should patients (or parents) push for more follow-up care? Should a psychiatrist be involved in treatment? Is therapy necessary?
For guidance on these issues, WebMD contacted several psychiatrists. Their advice:
1) Be your own (or your child's) advocate.
Primary care providers can generally diagnose clinical depression in adults. Sadness, difficulty concentrating, sleep problems, lack of energy, and hopelessness are classic symptoms. Discuss them with your doctor, and talk about all the treatment options.
However, with children and adolescents, depression is not so easy to diagnose, says David Fassler, MD, private practice child and adolescent psychiatrist and professor of psychiatry at the University of Vermont.
"Depressed kids don't always look like you would expect," he tells WebMD. "Quite often, they are not sad or withdrawn. They may be irritable, getting into fights, agitated. Getting an accurate diagnosis is key with kids. Some social workers and psychologists are good at recognizing depression in kids, as are some pediatricians and family practice physicians."
A psychiatrist's evaluation is often necessary to determine just what is going on with a child, he says. "Frequently, a child psychiatrist does the initial evaluation and prescribes medication. Then the child is referred back to the pediatrician for monitoring and follow-up, hopefully in conjunction with therapy."