Depression is a frequent condition which left untreated can significantly diminish our quality of life. At times it can be insidious and gradually creep up until it has taken over our lives. Sometimes there is an evident cause and by finding a rational explanation we might not treat the condition which by then might have become disabling and needs attention in its own right. Other times there is not an evident cause, and because of it we might find it hard to understand what is wrong with us. Sometimes a recurrent problem with low mood does not get better with the provided treatment but, why is this? Is it because of the diagnosis is not accurate, the treatment or other reasons? These can be explored in depth in this clinic where the treatment options will be tailored to the person's needs.
Depression prevalence in General Practice attendees is 10% (King et al 2008). Depressive illness often recurs after 5-10 years, and the prevalence is higher amongst people with Substance Misuse problems and with Anxiety Disorders. Major Depression can overlap with Dysthymia and an American survey suggests that Dysthymia affects 3% of the adult population (Weissman et al 1988). Similar results are revealed in a more recent study by Sansone (Sansone et al 2009). When it comes to medications, NICE guidelines establish protocols for the treatment of depression being the SSRIs the first line treatment. On many occasions the SSRIs, are not the treatment of choice and the medication needs to be tailored to the individual's needs, which might include more than one type of therapy.
A thorough assessment of symptoms, co-morbidities, concordance with treatment and other factors is instrumental to achieve a successful outcome. Sometimes the diagnosis needs being reviewed, as recurrent depression could be an undiagnosed Bipolar Illness which warrants a different treatment. On some occasions, Depression can be buried under Dysthymia which warrants a different approach.
This clinic gives health professionals the opportunity to refer patients with a Depressive Illness needing further input which cannot be provided within the constraints of a Primary Care consultation.