When I see a patient who has multiple problems; pain, unresolved issues, incomplete referrals, medication requests, it very often is a sign of depression.
Please hear what I'm saying without becoming defensive. Patients who have multiple concerns, keep me in the room longer than normal, cannot complete one sentence about one topic without moving onto another issue, are often crying or near tears, connect all of their problems that often include other people, and who request multiple medications (to address all their concerns), are usually depressed. Not always and not everyone, but often and usually.
As a provider, I listen to the patient, try to help them diagnose these concerns and when the concerns keep coming and multiplying, it finally hits me. I ask them if they think they could be depressed and they usually say yes.
Depression exacerbates symptoms. It makes pain feel more intense, it creates anxiety which can mimic a heart attack (chest pain, shortness of breath, palpitations), feels overwhelming, creates anger within a normal medical visit.
Fortunately at my clinic, my office is right next door to Behavioral Health. I am able to ask for a consult and right then and there the patient can be assessed for suicidal ideation or intent and scheduled for a counseling session or group therapy. I offer medication and supportive services.
Aside from the obvious medical issues most patients I encounter have (DM, HTN, obesity), depression and its friend, anxiety, are the next most common health issues.
If you think you are struggling with depression, please come talk to your provider. Please find a counselor. The work is hard, but the rewards are beautiful.
Below is a copy of a depression questionnaire we use to screen for depression. In our office, if you score 10 or more, we offer Behavioral Health services.
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