References
Prescribing for depression in primary care
Abstract
The term ‘depression’ covers a variety of mental health problems characterised by a loss of interest and enjoyment, low mood and other emotional, cognitive, physical, and behavioural symptoms. Most people experiencing depression are treated in primary care. These treatments include various talking therapies and support to aid physical, psychological and social wellbeing. For people with moderate-to-severe depression, treatment with medication is recommended. This may be prescribed in addition to therapy and support. It is important that the person diagnosed with depression is monitored to assess how they respond to the antidepressants. A different type may need to be offered if response is poor or they have intolerable side effects. Antidepressants need to be prescribed for a given period, the length of which is dependent on whether this is the first or a further episode.
Depression is a condition that can negatively affect how a person feels, thinks and behaves (Hardy, 2021). Although the symptoms of depression vary in every person, commonly people feel sad and find it difficult to engage in the activities they usually enjoy. A variety of emotional and physical problems are experienced, which reduce a person's capacity to perform both at work and at home. Depression has been cited as the second leading cause of disability globally (Vos et al, 2013). Recovery is affected by personality, resilience, family history, premorbid difficulties, relationships and social problems.
The level of severity in depression is determined as sub-threshold depression, mild depression, moderate depression, major depressive disorder (or severe depression). Some people experience persistent depressive disorder where symptoms are mild but affect functioning due to the duration experienced. The severity of depression can be measured using the Patient Health Questionnaire (PHQ-9). This is a nine-question tool which has been validated for use in primary care (Ford et al, 2020).
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