One in three GP appointments now involve some discussion around mental health, and while people are starting to feel more comfortable talking about their struggles with mental health in the media, it can still be a stressful experience broaching the subject with a doctor.
To help put your mind at rest, here are some of the steps to expect when you first visit your GP:
When you arrive:
Firstly, your doctor will give you the space to express why you are there and what your concerns are. We are here to listen to you in a confidential, non-judgemental environment and this will ideally be the biggest part of the consultation, as it will help us better understand your symptoms and the potential causes of your depression. Some people find it is easier to write everything down on a piece of paper to bring along as a reference point if they are struggling, or bring a close friend or family member along for moral support, so do whatever makes you feel most comfortable. The typical appointment time is 10 minutes, but you can book a double appointment if you feel you need more time.
When you are discussing your symptoms, your doctor will go through a number of questions to help establish what the underlying cause may be and the physical and emotional symptoms that are effecting you. Some questions might be:
• What are the triggers that are causing you to feel so low?
• Is there any history of alcohol or drug use which could be a contributory factor?
• Have you suffered with depression or any other mental health problems before?
• What physical symptoms of depression are you suffering from (such as poor sleep, loss of appetite etc)?
• Do you have any thoughts or plans of self-harming?
Once you have spoken about what you feel the underlying causes are, your GP will then look through your medical history to ensure that there aren't any physical problems that might be impacting your mental wellbeing, before asking you to fill in a Patient Health Questionnaire. While this is not a screening tool for depression, it monitors the severity of your depression and your responses to treatment based on the scores you give to each answer, which will in turn help the doctor establish next steps.
Once you have discussed how you are feeling and the symptoms, your doctor will talk you through next steps, whether that is a long or short-term management plan. This plan will encompass the symptoms you are experiencing, your previous medical history and your thoughts around what type of interventions would be most appropriate for you. Treatment options include:
Small changes such as reducing alcohol intake and increasing exercise can be extremely effective in improving mood and overall health and wellbeing and is a good first step. Recent research from Central Queensland University has proven this, as a study of 92 people revealed that physical activity reduced depression and anxiety in non-clinical populations. Creating a structure and routine may in itself help you feel more in control of the situation.
There is the option to be referred to the NHS or private counselling, or be placed on a course of cognitive behavioural therapy. CBT aims to help you deal with overwhelming problems in a positive way by breaking them down into smaller parts, helping to improve your state of mind on a daily basis.
If you're feeling particularly vulnerable and have tried the previous options, you doctor can prescribe medication. There are a wide variety of medication options to choose from but your doctor will guide you in choosing the most appropriate treatment given the nature and severity of your symptoms.
If you still feel uncomfortable talking to your GP, look online for some of the fantastic services that can help you anonymously. Sites, such as Big White Wall or MIND, can provide you with services, which are often free, and offer you support and advice without a referral. Yet it is important to remember that if any point you are feeling low or having thoughts of self-harm that you seek urgent medical attention either by contacting your own GP, the NHS 111 service or alternatively going directly to A&E to seek medical attention if these avenues to care prove to be unsuccessful.