If you have depression, it's important to seek help. Professionals you should turn to might include your regular health care provider, a psychologist, social worker or therapist, or a psychiatrist or psychiatric nurse practitioner.
But finding the right people may seem intimidating. Here are some answers to common questions about finding help. Following these questions, you'll find a list of tips for how to prepare for your first appointment.
What kind of help do I need? It depends on the severity of your illness and what you've tried before. Both talk therapy and medication can be helpful. Often a combination of both is recommended. The Mental Health Parity and Addiction Equity Act of 2008 requires that health insurance plans to 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.
Can I just see one doctor? Your primary care doctor can be a great resource. They can prescribe medication and, talk to you about lifestyle changes, and in some cases provide talk therapy. You should let your primary care doctor know if you're concerned about depression. They can offer tests to rule out medical conditions that may contribute to your symptoms. Primary care doctors routinely prescribe medications for depression, but if your case is complicated or the treatments don't work for you, your doctor may recommend you see a psychiatrist who specializes in the treatment of mental illnesses. Many primary care doctors can provide brief counseling, but if you need intensive or specialized treatment, you may turn to a psychologist, social worker, or psychiatrist for therapy.
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 the National Alliance on Mental Illness or SAMHSA, the Substance Abuse and Mental Health Services Association, which can suggest experts in your area. If you have health insurance, the insurer can let you know about providers who are in your network. Most counties also have community service boards that can provide or recommend treatment.
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 their 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.
What if I'm in a crisis? Sometimes, people with depression feel as if life is not worth living or have thoughts of harming themselves. If that should happen to you, go to a local emergency room or call 911 or a crisis hotline such as the SAMHSA national crisis hotline at 800-273-8255.
Depression Therapy: Preparing for Your First Appointment
It's not always easy to open up about your personal issues with someone. So be prepared. Before you first see your doctor or therapist, think about what you'd like to talk about. Consider your goals. 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. 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.