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Are you feeling down or hopeless? You’re not alone. The Center for Disease Control and Prevention states that 1 out of 20 Americans are depressed. Depression disorders are common, costly and treatable, but they often go unrecognized. Thanks to an increased emphasis on depression screenings in primary care offices, more physicians are evaluating mood just as they would assess diabetes or high blood pressure.

Ever Ponciano, M.D., internist with Meritus Internal Medicine, believes that doctors must feel at ease with the topic in order for patients to open up about their feelings.

He immerses questions like “How’s your energy?” or “Are you having trouble sleeping or sleeping too much?” into the general conversation about overall health. Responses to these questions and certain risk factors trigger him to take a deeper dive into a patient’s state of mental health.

Depression influencers

Risk factors for depression include chronic pain, chronic medical conditions, substance abuse, trauma, financial struggles, prior depression and a family history of depression. Anxiety, says Dr. Ponciano, is a close cousin to depression.

The primary care physician’s office is exactly the right place to have a conversation about depression,” says Dr. Ponciano. “With depression, you have a lower quality of life—and the condition is linked to poor physical health.” Stress affects blood pressure and blood sugar and an apathetic attitude can also affect a person’s willingness to take care of himself or take prescribed medications.

A way out of depression

For milder forms of depression, physicians may recommend natural steps such as eating a healthy diet, getting adequate sleep, exercising and establishing a routine. When depression symptoms are significant, Dr. Ponciano encourages his patients to see a therapist. “Therapists have the skills to get to the heart of why things are happening, suggest ways to get out of problems and help patients learn coping skills,” says Dr. Ponciano. Other forms of therapy can include art therapy, mediation, pastoral counseling and family therapy.

To bring behavioral health services to patients, Meritus Health includes behavioral health specialists in Meritus Medical Group primary care practices. According to Dr. Ponciano, some behavioral health issues can be successfully identified and treated in the primary care setting with the right support.

Medications are also key to curbing depression. Selective Serotonin Reuptake Inhibitors or SSRIs are the most commonly prescribed type of antidepressants and some also work to address sleeplessness or smoking cessation. Serotonin-norepinephrine Reuptake Inhibitors or SNRIs are another class of medications used for the treatment of depression and chronic pain.

Dr. Ponciano helps patients understand possible side effects and the time it takes for the medication to become effective. He warns that abruptly stopping antidepressant treatment or missing doses can cause withdrawal-like symptoms.

A relationship with your PCP

While primary care physicians like Dr. Ponciano don’t provide counseling for patients struggling with depression, they remain involved in ongoing care. He encourages his patients to make at least three follow up appointments to evaluate medication effectiveness, side effects and/or results of therapy. “There is a way out of depression and with the right help, people will be better off than they were before beginning treatment,” says Dr. Ponciano.