What should happen when I first talk to a healthcare professional about depression?

What should happen when I first talk to a healthcare professional about depression?

Your GP (or another healthcare professional who is treating you for your physical health problem, such as a nurse or hospital doctor) may ask you whether you have been bothered by feeling down, depressed or hopeless and/or by having little interest or pleasure in doing things in the past month. If your answers indicate that you may have depression, you should be offered an assessment. The assessment should be with someone experienced in treating people with mental health problems – this may be the person who asked you the questions.

Assessment

The assessment will enable your healthcare professional to identify whether you have depression. If you do, they will assess what level of depression you have (see box in Mild, moderate severe depression) and how your physical health problem has affected you. They will also discuss with you which treatments for depression would suit you best. They may ask you about:

  • your thoughts, feelings and behaviour (including whether you have been bothered by feelings of worthlessness, poor concentration or thoughts of death)

  • how long you have had your symptoms, and how they are affecting your everyday life

  • your relationships, and your living and working arrangements

  • whether you have had depression or other mental health problems before – and if so, whether any treatments were helpful

  • your physical health problem, including any medication you are taking for it and any other treatment you are having.

You may be asked to answer a written questionnaire.

When assessing you, healthcare professionals should take account of any learning disabilities or other problems that may affect your ability to respond to questions.

Some people find it difficult to discuss their depression, so your confidentiality, privacy and dignity should be respected at all times.

Healthcare professionals should be aware of any sensitive issues relating to being diagnosed with depression, and should build a relationship with you based on openness, trust, hope and optimism. They should explain the different ways in which depression develops. They should also discuss the treatments described in this information with you and explain that these can help people to recover from depression. You should be told about self-help groups and support groups for people with depression.

Support for people who might harm themselves

You (and your family or carer if you agree) should be advised to look out for negative thoughts, changes in behaviour (such as avoiding social activities and contact with other people, or not looking after yourself properly), hopelessness, changes in mood and thoughts about suicide. This is particularly important during stressful periods or when you have just started a new treatment for depression. You should contact your GP or another healthcare professional if any of these occur and you are worried.

You should also be asked whether you have had thoughts about suicide or harming yourself. If you have, your healthcare professional should make sure you have support and give you information about where you can get further help. You should call your GP or another professional if you are not able to cope and your thoughts about suicide become more intense. They will offer you more help, and talk with you and/or see you more frequently. If there is a strong risk that you might harm yourself (or others), you may be referred to a specialist mental health service.

Questions you might like to ask your care team

  • Why am I being offered an assessment?

  • Why have I been diagnosed with depression?

  • What type of depression do you think I have?

  • What does having depression mean for my health/daily life/work?

  • Will I have to go into hospital to get treatment for depression?

  • What could have caused my symptoms of depression?

  • How will my progress be monitored and who can I contact if my depression gets worse?

  • Will my diagnosis and treatment of depression remain confidential?

  • Are there any support organisations in my local area for depression and/or my physical health problem?

  • Information Standard