Convincing the Depressed to Seek Treatment

Convincing the Depressed to Seek Treatment

Posted Fri, Dec 19, 2008, 11:24 am PST
100% of users found this article helpful.
Post a Comment View All 1 Comment

In my experience, it is sometimes hard to convince a patient that his or her symptoms are due to depression. Even more difficult, however, is getting a depressed person to do something about the problem.
I think of treatments for depression as falling into three broad categories—home remedies, counseling, and medication. I'll write more about each of these in the future, but for now let's concentrate on how a patient who is depressed makes the decision to deal with the problem. Perhaps you will recognize in yourself or a friend one or more of the following excuses for not seeking treatment:

Denial:
"Why should I do anything about a problem that doesn't exist?" Obviously, people who don't accept a diagnosis of depression, anxiety, or related mood disorder will resist treatment. Many cultures attach a lot of stigma to mental illness, so people naturally don't like to be labeled as depressed or anxious. Sometimes this issue can be solved with a different choice of words. Situational dysthymia (low mood in response to a stressful situation) may, for example, sound much less threatening to a patient than depression. Open communication between the patient, the health care provider(s), and friends and family members can be very important in reaching a mutually acceptable diagnosis, so that the conversation can move on to creating a treatment plan.

"I can take care of it myself."
Even after acknowledging that they are depressed or anxious, patients often tell me that they don't need any treatment—they'll just deal with it themselves, or wait for the stressful situation to resolve. In part, this is an extension of the stigma associated with depression. Admitting to needing help dealing with issues is often seen as a sign of weakness. This can also become a secondary form of denial, something akin to "Okay, maybe I'm a little depressed, but it isn't severe enough to need treatment."
In some cases, these feelings are correct. A temporary cause of depression may resolve, or the patient may eventually develop his or her own coping strategies and get back to a happier and healthier lifestyle. But frequently, one upsetting situation is followed by a new source of stress, or the depression is due to multiple other factors that aren't likely to change on their own in the near future, so the symptoms of depression continue for a prolonged period. And those who do get better without special assistance often could have improved sooner by dealing with the issue head-on.

"I don't have time to deal with it."
It's true that there are only 24 hours in a day, and we all must make decisions about how to spend those hours. Taking steps to deal with depression may very well mean that there is less time available to do something else. Like so many other things, this becomes a matter of setting priorities. If depression is causing bothersome symptoms or otherwise reducing the quality of life, spending some time working on solving the problem is probably worth it. In the end, the payoff is often more time to get other things done—and more enjoyment of those things—once the depression has lifted and the patient has more energy and motivation and improved mental sharpness.

"It costs too much."
While there are a few inexpensive ways of managing depression, many of the approaches to treatment do cost some money. Health insurance has been notoriously poor at covering many of these expenses. The Federal Mental Health Parity Act of 1996 attempted to require that mental health benefits be comparable to other health benefits, but the Act left many loopholes. The Mental Health Parity and Addiction Equity Act of 2008, which takes full effect in October 2009, is expected to bring coverage for mental health care more into line with insurance payments for mainly physical disorders.
There is also the problem that many people simply lack health insurance entirely. Clearly, there is no simple solution to these financial issues, but there are a variety of programs available to help cover the costs of counseling and/or medications for those with limited financial resources. The first step is to make a commitment to treat the depression. After that, the challenge is to choose the least expensive treatment methods and find the financial help to pay for them.

Preconceived notions.
Many people have strong negative feelings about counseling and medications. Most of the time, these fears and negative expectations far exceed the reality.

With a measure of patience and carefully monitored treatment, most patients who suffer from depression, low mood, and/or anxiety can get back to a normal life with few inconveniences or side effects. The key is to get past denial and fear of stigma, so that the healing can begin.

© 2007 Johns Hopkins University. All Rights Reserved. This article from Johns Hopkins University is provided as a service by Yahoo. All materials are produced independently by Johns Hopkins University, which is solely responsible for its content.

http://health.yahoo.com/experts/yourhealth/3080/convincing-the-depressed-to-seek-treatment/