Coping with Depression

Pronounced depression often requires a visit to a doctor or psychotherapist. The better you prepare for this visit the more likely you are to receive the treatment you need. This includes, for example, describing your complaints as precisely as possible, informing yourself before the medical examination and asking questions during the consultation. In this way you can contribute to a partner-like relationship with your doctor, which can have a positive effect on the success of your treatment.

The contents you find here are based on the research of Prof. Martin Härter on “participative decision-taking”. This mutual decision-taking by doctor and patient is recommended by leading experts in the current German S3 Guidelines for the Treatment of Depression. You can find more detailed information and more working materials under www.patient-als-partner.de (also in English).

Prepare yourself for the Consultation

The best idea would be for you to print out the PDF documents you are offered here and take them with you to the medical examination.

With the help of these documents it will be all the easier for your doctor or therapist to diagnose and treat your illness in the best possible way. In this situation this free depression screener can also be helpful.

The preparation for your first consultation with your doctor or psychotherapist consists essentially in the following points:

1. Explain in your own words the symptoms you are suffering from and the concerns you have about them.
2. Make it clear in your own mind what you want and what is important for you (for example the effectiveness or tolerability of a form of treatment.)
3. Think about the questions you want to ask your doctor or psychotherapist.

Describing complaints and case history
For your doctor the description of your complaints is an important source of information on which further treatment will be built. It is also helpful to know what possibly led to the complaints, what you have already undertaken to deal with them and whether the illness has a pre-history, etc.

Preparation for the examination

It would be best if you print this checklist out, fill it in and take it with you to your doctor.

Acquire information yourself and evaluate it critically

There are numerous opportunities for acquiring information about depression. Points of contact and tips on literature can be found for example in:

• American Psychological Association (APA)
• Agency for Healthcare Research and Quality
• American Medical Association
• National Institute of Mental Health
• Mental Health America
• Burns DD. Feeling Good - the new mood therapy. New York: Avon Books, 1999
• Holdsworth N, Paxton R. Managing anxiety and depression. London: Mental Foundation, 1999
• Lewinsohn PM, Munoz RA, Youngren MA. Control your depression. London: Simon & Schuster Books, 1992
• Greenberger D, Padesky CA. Mind over mood: change how you feel by changing the way you think. New York: The Guildford Press
• Williams C. Overcoming depression: a five areas approach. London: Arnold, 2001.

There are many other sources, for example books, websites television items and articles in magazines.

You can find well-informed information on depression on the website of your health insurance company. Detailed online information can be found e.g. on the websites of the following insurance providers (US):

• AARP
• Aetna
• Cigna
• United Health Group

In order to decide which sources are suitable and which not you can evaluate them critically with the help of a checklist. The questions you should consider are:

• Who is offering the information?
• Are there references to the authors and their qualifications?
• Which interest groups are involved in the publication of the information?
• Is the information up to date? When was it published and last revised?
• How was the information service financed? Is the independence of the editors guaranteed or are there conflicts of interest?

Get to know your own needs

To get the best possible treatment it is good to know as precisely as possible what you are hoping for. Ask yourself, for example: What do I want to achieve? Do I simply want to get rid of my symptoms or do I want to prevent them from returning? Other wishes may be added to these. Do you want to take antidepressants? Or would you prefer to get rid of your complaints by other means?

Make a few notes and take them with you to your doctor or therapist. This document can help you. In this worksheet you can record your aims for the treatment, the alternatives (and their advantages and disadvantages) and what might suit you best.

Possible forms of treatment

It is perfectly possible that you cannot answer one or the other question immediately. But these are precisely the things that you should then discuss with your doctor or therapist.

Ask the right questions

The more actively you participate in the discussion with your doctor or therapist the more you will contribute to a good treatment of your depression. This also includes asking your doctor or therapist questions.

Consider in advance what you want to ask. What would you like to know? Something, for example, about possible therapy forms? How effective are the forms of treatment? Are there alternatives? What about the side-effects?

This list can provide you with some indication of the possible questions you want your doctor to answer.

Questions for the visit to the doctor or psychotherapist

It would be best to print this list out and take it with you to your appointment. Do not be shy about asking your doctor or therapist questions. Long years of experience have shown that patients who are well prepared can work together purposefully with their doctor in order to arrive at a joint decision.