To get better, you need expert help. Many people with depression have a team working with them. This might include your regular health care provider, a psychologist or therapist, and a psychiatrist or psychiatric nurse.
But getting the right people may seem intimidating. Here are some answers to common questions about finding a doctor and psychologist or therapist. Following these questions, you’ll find a list of tips for how to prepare for your first appointment.
- What kind of expert do I need to see? People with depression often see a few different experts. You might see a non-MD therapist as well as a doctor or nurse for medicine. The Mental Health Parity and Addiction Equity Act of 2008 requires that health insurance plans do not put restrictions on coverage for mental health services that are different from coverage for other medical or surgical treatment. The Patient Protection and Affordable Care Act provides federal support for low-income individuals to obtain health insurance. Some mental health professionals or clinics also offer a sliding scale based on income.
- Why can't I just see one doctor? Your primary care doctor can prescribe antidepressants, but family doctors usually don’t have expertise in prescribing drugs for treating psychological conditions. So if the first or second antidepressant you try does not help, your doctor may recommend that you see a psychiatrist who can better prescribe the medicines you need. Primary care doctors also are not trained to practice psychotherapy. So you may turn to a psychologist, social worker, or psychiatrist for therapy. Psychiatrists are doctors who can prescribe antidepressants and other medications and sometimes also offer therapy. They are, though, often more expensive than non-MDs.
- How do I find a therapist or a psychiatrist? Ask your regular doctor for a recommendation. You can also get in touch with organizations such as NAMI, the National Alliance for the Mentally Ill, which can suggest experts in your area. Keep in mind that anyone can call himself or herself a "therapist." Your therapist should be a licensed psychiatrist, psychologist, social worker, psychiatric nurse, or counselor.
- What should I look for? Therapists and psychiatrists use many different approaches. Some focus on practical, here-and-now issues. Others go deeper, probing events from your past that might have played a role in your depression. There are specific forms of psychotherapy that have been shown to be helpful for depression - such as cognitive behavior therapy or interpersonal psychotherapy. Many therapists use a mix of styles. When you first talk to a potential therapist or psychiatrist, ask about his or her approach to see whether it seems appropriate for you and your condition. If it’s not a good fit, find someone else. If you don't click with a person, therapy is less likely to help. You may also want to look for someone who specializes in your particular problem. For instance, if you have a problem with drugs or alcohol, find a doctor or nonmedical therapist who specializes in treating people struggling with addiction.
- What if treatment doesn't help? Once you've settled on a therapist and doctor, you need to give therapy and medication a chance to work. Getting better takes time, often several months. Treatment for depression can be hard at first. Opening up to someone about very personal things in your life isn't easy. But most people do get better with treatment.
Depression Therapy: Preparing for Your First Appointment
It's easy to get flustered when you're first meeting with a doctor, psychologist, or other therapist. So be prepared. Before you first see your doctor or therapist, decide what you'd like to talk about. Think about what you want from treatment. Go in with information and questions.
Here are four key ways to prepare.
1. Write down questions.
Come up with some specific things you want to ask. Don't assume that your doctor will tell you everything you need to know.
For instance, you might ask your doctor:
- Do I need medicine for my depression?
- What kind of medicine will you prescribe?
- What are the side effects and risks?
- How often do I need to take it?
- How quickly will it work?
- Will any of my other medications, herbs, or supplements interact with this medicine?
You could ask your therapist:
- What kind of approach do you use? What will our goals be?
- What will you expect of me? Will you give me specific assignments to do between sessions?
- How often will we meet?
- How do we decide whether therapy will be short-term or long-term?
How much does each session cost, and what is your policy for cancellations or missed appointments?
2. Keep a log or journal.
Keeping track of your mood changes in a diary can be helpful to you, your doctor, and your psychologist or therapist. Just jot down a few lines each day. In each entry, include:
- How you're feeling that day
- Your current symptoms
- Any events that might have affected your mood
- How much sleep you got the night before
- The exact doses of any medicines you took
Bring your journal to your first appointment. Show it to your doctor and therapist. If you keep a journal for a few weeks or months, you may start to see patterns to your mood changes that you never noticed before.
3. Don't forget about your physical symptoms.
You might not think that they're relevant, but physical symptoms are often signs of depression. Make sure to tell your doctor or therapist about pain, stomach problems, sleep problems, or any other physical symptoms. In some cases, you may need treatment for these symptoms.
4. Get help from friends or family members.
Ask them about changes they've noticed in your behavior. They may have seen symptoms that you missed. And if you're nervous about your first appointment, ask for a friend or family member to come along.