What if screen is positive?
Confirm diagnosis by doing a more detailed questionnaire or by referring to a mental health provider
Rule out differential diagnoses: substance abuse, bereavement, bipolar disorder, hypothyroidism, anemia, and other medical conditions1
Assess all patients with depression for suicidal or homicidal ideation2
Modes of treatment:
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Lifestyle modifications: exercise, sunlight exposure, stress management, healthy sleep habits
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Counseling (individual or group)
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Psychotherapy: consider cognitive-behavioral therapy, interpersonal psychotherapy, psychodynamic therapy, and problem-solving therapy; may be used in combination with pharmacotherapy2
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Pharmacotherapy with antidepressants2
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Electroconvulsive therapy (ECT): consider in patients with severe, unresponsive depression2
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Other therapies: transcranial magnetic stimulation (TMS), light therapy, alternative medications such as St. John’s wort2
The Maternal and Child Health Bureau created a brochure: Women and Depression Across the Lifespan. The brochure can be ordered by completing the MCH Publications Order Form.
References:
- Maurer DM. Screening for depression. Am Fam Physician. 2012 Jan 15; 85(2):139-44.
- American Psychiatric Association: Practice Guideline for the Treatment of Patients with Major Depressive Disorder, Third Edition, 2010. http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf (Accessed on December 4, 2014).
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