Physicians Should Be Screening Every Patient for Depression, U.S. Task Force Says

Your doctor may start asking about your mood. And that's a good thing.

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Don't be surprised if your doctor has a few extra questions for you during your next exam about your outlook, energy levels, sleeping habits, and ability to concentrate.

On Tuesday, the U.S. Preventive Services Task Force released a recommendation for clinicians to screen all U.S. adults for depression. The recommendation also urges primary care doctors, gynecologists, and obstetricians to screen women who are pregnant or have recently given birth.

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"Although major depressive disorder (MDD) is one of the world's great public health problems, the morbidity and increased mortality associated with this common illness can be attenuated by the large number of effective treatments that are now widely available," wrote Michael E. Thase, MD, in an article about the new recommendations that was published online in The Journal of the American Medical Association.

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Dr. Thase suggests that people with a history of depression should be screened during each visit, patients being treated for chronic medical conditions should be screened each year, and adults in "generally good health who only see their primary care physicians sporadically, it may make sense to screen at each visit."

Screening for Depression: A Great First Step

"By having this recommendation come out, I think we're making great strides in the right direction about putting mental illness as a priority," says Stacy Kaiser, a licensed psychotherapist based in southern California.

In 2014, nearly 7 percent of U.S. adults suffered from at least one major depressive episode, which is defined by the National Institute for Mental Heath as "a period of two weeks or longer during which there is either depressed mood or loss of interest or pleasure, and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration and self-image."

Dr. Kaiser believes that number is actually much higher. "Those are the adults we know about because most people don't realize they have depression until an expert tells them," she says. "They just walk around thinking, 'I feel bad, I'm sad, I'm not motivated,' but they don't know why."

Overcoming the Stigma and Myths

There is also a common misconception about depression that prevents many people from pursuing diagnosis and treatment: "Extremely depressed people cannot get out of bed, but people who are mildly depressed or significantly depressed can get out of bed and do lots of typical things — like go to work and feed their families—yet they're suffering on the inside," Kaiser explains. "The truth is you can be dealing with a significant amount of depression and still function."

And then there's the stigma. "When people have psychological problems, they don't want to talk about it," Kaiser says. "Often times, they won't even mention it to their primary care physician or gynecologist. Or they'll assume their doctor only wants to hear about their physical ailments, so they don't even think to bring up their emotions. So this screening can help people get educated in order to be treated."

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