When a patient suspects he or she may have clinical depression and require treatment, a common first step is to see the family doctor. After all, mental health is a very personal subject, and most people don’t want to receive depression treatment from a complete stranger! Another common issue is that patients associate the word “psychiatrist” with scary-looking mental health asylums that don’t exist anymore and lots of medications with side effects. The reality is that seeing an appropriately trained mental health professional instead of a general practitioner (GP) could save a patient’s life.
According to this study, although more and more patients are seeing a mental health professional rather than a GP, 43% still see their family physicians for mental health concerns; the vast majority of these people who did not see a mental health professional didn’t do so because of the stigma that unfortunately seems to still exist in some populations. This study also showed that more than half of patients who visited a GP for concerns of deep sadness lasting for unnaturally long periods of time, with or without cause, were diagnosed incorrectly, leading to years of taking unnecessary medications at best, or possibly worsening the actual condition!
Although it’s still possible that a psychiatrist could misdiagnose a patient, it’s unlikely that the misdiagnosis would persist, since they would be more familiar with mental health issue differentiation than a standard doctor would be. The current standards for depression treatment in the United States and most of Western Europe are at least one course of psychotherapy combined with one or more antidepressants. Though older, tricyclic antidepressants are still used, Selective Serotonin Re-uptake Inhibitors, or SSRIs, are the most popular choice.
An improper diagnosis leading to classic depression treatment can be life-altering. According to Managed Healthcare Executive, about 70 percent of people who actually have bipolar disorder are incorrectly diagnosed as being depressed. Bipolar Disorder has two types, though both of them have a similar structure: periods of lower mood followed by periods of higher mood. Individuals with bipolar are more likely to seek help during a lower mood period, which clinically presents identically. Unless the patient is under observation, a single office visit with complaints of low mood cannot lead to an affirmative bipolar diagnosis. It’s gravely important to understand that, while SSRIs are a great tool in combating true depression, they can actually worsen rapid mood cycling in those suffering from bipolar disorder.
A GP may just see this rapid cycling as a need to increase the dose, further worsening existing symptoms. Remember, a psychiatrist has spent years in residency and training in mental health environments and is well-versed in current treatments and patient safety. A GP may have varying levels of knowledge in this category, so it’s more of a gamble. The brain is a complex machine, often requiring refined knowledge to identify outstanding psychiatric disorders. Although it may be more convenient to pop over to the family physician and pick up a prescription and be done with it, mental health issues can be insidious and hard to recognize. Although a GP can legally prescribe these medications, oversight should be done by someone who can recognize potential side effects and problems they cause before it gets too late.
Perhaps an analogy can drive the point across. Consider a house with a broken water heater. A real estate agent is easier to find than a good plumber, and they are licensed and must take exams demonstrating they know the basics of the components of a house. However, real estate agents are not experts in water heater repair! A plumber will be more costly and take more time, but you know that the plumber will be able to accurately fix and diagnose the issue because that is their specialty. Just as you wouldn’t choose to hire a real estate agent to fix your water heater, don’t hire a general practitioner to evaluate you or a loved one for depression! Choose a doctor whose specialty is in that for a much higher chance of a happy, successful outcome!