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Depressed or stressed? You are not alone

If you are feeling down or hopeless, you’re not alone. According to the Centers for Disease Control and Prevention, an estimated 1 in 10 adults suffer from some type of mood disorder, with depression being one of the two most common. Depression disorders are 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.

Starting the conversation.

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

“Often I’ll ask my patient ‘How’s your energy?’ or ‘Are you having trouble sleeping?’ as part of our general conversation about overall health,” he says. A patient’s responses along with certain risk factors trigger him to take a deeper dive into the person’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 often poor physical health. Stress can affect a patient’s blood pressure or blood sugar, common topics of discussion with your regular doctor.”

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 seek “talk therapy.”

“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,” he says. Other forms of therapy include art therapy, meditation, pastoral counseling and family therapy.

Help right where you are.

To bring these services right 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 may begin in the primary care setting with the right support.

Alongside counseling, medications can be key to curbing depression, including Selective Serotonin Reuptake Inhibitors or SSRIs, the most commonly prescribed type of antidepressants, or Serotonin-Norepinephrine Reuptake Inhibitors or SNRIs.

“As a patient’s primary care physician, I can help him/her understand possible side effects of medications and how long they need to be in a person’s system to become effective,” says Dr. Ponciano. He warns that abruptly stopping antidepressant treatment or missing doses can cause withdrawal-like symptoms, “so it’s important to follow the directions on any prescription medication and have an open line of communication with your doctor on how you are feeling while taking the medication.”

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.

“With the right help, people will be better off than they were before beginning treatment,” he says.

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