Your family doctor should have a very good grasp of both the symptoms and treatment options relating to depression. Ideally, his knowledge and your needs should mesh, so that any treatment he recommends comes after a discussion and understanding of your situation.
Unfortunately, the treatment of depression isn’t without its downsides, so it’s important that you understand the implications of treatment before you accept it.
At its most basic your doctor must first obtain your consent before prescribing medication. There’s an important principle at work here. Consent isn’t just about doctors saying what they think is for the best and you following their recommendation. Consent is actually more complex, and the key word here is informed. Informed consent means that you fully understand what your doctor is saying and that you have been able to weigh the benefits and limitations of the treatment options on offer. It also means that you have been given the chance to ask questions, that you are entering freely into treatment, and that you are not being forced down any particular path.
For something as complex as depression, informed consent may be difficult. It requires focus and concentration on what the doctor is saying — both of which are in short supply in major depression.
Your immediate need for the doctor to simply do something for you may overshadow the importance of taking the time to properly evaluate what is being said. Your doctor may even suggest you take some time to weigh up the options. This has the merit of allowing you time without pressure, but it has the disadvantage of leaving you for longer without treatment.
Bear in mind that antidepressants can take many days or weeks before any therapeutic effect is felt, so a day or two extra is unlikely to make much difference.
Having your say
It’s easier to enter into a proper conversation if you have some grasp of the essentials. A simple internet search about the signs, symptoms, and treatment options for depression is likely to help in this regard. Your visit provides an opportunity to ask questions about things you don’t understand. You may also find that your pharmacist can provide more detailed information about any medication you have been prescribed. Don’t be afraid to ask questions and to keep asking questions if you still don’t understand.
Trial and error
Don’t be alarmed if your doctor says antidepressant medication may not suit you. Unfortunately there is currently no way to work out whether a particular antidepressant will work. The same tablets given to different people can have markedly different outcomes. Some people will experience side effects, others not; some will feel benefits and others not. So far as antidepressants are concerned, a little trial-and-error isn’t uncommon. The dosage may need to be modified and sometimes the medication itself may need to be swapped.
The final say
Your doctor has a duty to inform you about the merits and availability of treatment. He should answer your questions and, so far as possible, try to accommodate your own needs and preferences. Your doctor has the final say over what he is prepared to prescribe. He will take into account your background, any pre-existing conditions or treatments, and come to a decision based on the likely success of treatment.
You have a say, too, but understanding why your doctor may refuse a course of action can sometimes be as important as knowing why he recommends an alternative. Use the time with your doctor to your advantage.
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Dr. Jerry Kennard is a Chartered Psychologist and Associate Fellow of the British Psychological Society. Jerry’s clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.