Many don't want to tell doctors about depression

Some people with depression symptoms may not tell their family doctor about their issues, often out of worry they will be placed on an antidepressant, a study said.

In a survey of more than 1,000 adults, researchers led by Robert Bell at the University of California at Davis found that 43 percent had at least some misgivings about telling their primary care doctor about any depression symptoms.

Their top concern was the possibility that their doctor would prescribe an antidepressant, a worry voiced by 23 percent of the whole study group.

"Many adults subscribe to beliefs likely to inhibit explicit requests for help from their primary care physician during a depressive episode," wrote Bell and his colleagues in the Annals of Family Medicine.

Another 16 percent thought it was not their doctor's job to "deal with emotional issues." And a similar percentage worried that someone, like an employer, might see a diagnosis of depression on their medical records.

"This study raises interesting issues that have not really been addressed before," said David Hellerstein of the New York State Psychiatric Institute and Columbia University Medical Center in New York.

According to Hellerstein, who was not involved in the study, past research has generally focused on the doctor's side of things, such as whether and how they ask patients about depression symptoms.

Now it would be helpful for studies to look into why people harbor the attitudes they do, he said.

"On one level, it doesn't make sense. If you have depression, why would you worry about getting a treatment that's effective?" he added.

Some people may worry about side effects, or that medication won't help.

The most common side effects of antidepressants include constipation, headaches, dizziness, sleep problems and weight gain. Some drugs have also been linked to reports of suicidal behavior in children and young adults.

As for effectiveness, about 60 percent of people who go on antidepressants "feel better" with the first drug they try, says the U.S. Agency for Healthcare Research and Quality.

In the current study, though, people seemed to have more misgivings about antidepressant treatment than they did about "talk therapy." Just under 14 percent said they might not tell their doctor about any depression symptoms out of concern they would be referred for counseling — versus the 23 percent who cited antidepressant worries.

Hellerstein said that 20 years ago, there might have been more stigma attached to "talking about your feelings." But that may be lessening now.

The findings were based on telephone interviews with 1,054 adults who were asked about their beliefs about depression, and "perceived barriers" to getting care for it. They were also screened for current depression symptoms, and asked about any past depression treatment.

Overall, 153 respondents screened positive for moderate to severe depression — and they were more likely to have an aversion to antidepressant treatment, 28 percent versus 18 percent. They also tended to see more obstacles overall.

"Ironically, those most subscribed to potential reasons for not talking to a primary care physician about their depression tended to be those who had the greatest potential to benefit from such conversations," wrote Bell.

Hellerstein noted that depression is something that can be discussed with a primary care physician and said that people should know that if they don't want to take antidepressants, they don't have to.

"But medication and psychotherapy can be effective," he added.

43% of those surveyed had misgivings about telling their doctor about any depression symptoms.

University of California Davis

sunday@tribune.com

Copyright © 2014, Los Angeles Times
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