Originally Posted by philipsmom
I have been doing medical transcription for family practice for the last few years, and I know what doctors diagnose, perhaps more than anyone else other than the doctors themselves, and I have been wondering lately if depression is over diagnosed in family practice settings.
Doctors, understandably, seem to have a "fix it" mentality and when there exists a lack of objective findings, it is so "convenient" for doctors to hand out antidepressants. Am I right about this? It happened to myself as well. I am a 28-year-old female who recently recovered from a more than 2-year-long febrile illness with fatigue, anorexia, and weight loss (down to 87 lbs at one point)--no objective findings. So a doc gave me samples of Lexapro. I don't agree with that practice! Am I the only one?
It seems that they become "comfortable" with the proposed safety of antidepressants that they feel they can just hand them out like candy. In fact, I typed a report rather recently of a case where Paxil was given to a 12 year old!! Last I knew the FDA had not approved Paxil for use in children. Am I correct? So, why are these issues coming up? I really do not think that diagnosing and treating depression in such a light manner is very wise.
One more thing to think about: Is it also possible that physicians often confuse normal sadness and emotions or "emotional expression" with pathological depression or anxiety?? If I happen to tell a doctor that I have been "feeling depressed lately" along with whatever other symptoms I may be experiencing (could be about anything) I guarantee he/she will offer an antidepressant. Is that right? It is normal for everyone to "feel" depressed sometimes. One pt on an SSRI said that she had been "unable to cry" since she had been on the drug and was pleased, so the doc kept her on it. What?? I certainly don't want to be on anything that might deprive me of my God-given ability to cry and feel sad. Sorry, I don't think that should be the goal at all. I believe that pathological depression and "feeling sad" or "feeling depressed" are two different things, and a lot of family practitioners don't seem to realize the difference or care. Is it a coincidence that more women are diagnosed with depression/anxiety than men? Or could it be that women are the ones more likely to be emotionally expressive, and that just doesn't fly in the modern American corporate world, so we must synthetically repress such things? I am actually starting to think that true pathological depression is a lot more rare than one might think. There is a difference between depression that controls our lives and drives one to suicide and the ability and wonder of feeling sadness, depression, or even anxiety. Anyone agree?
i see what you are saying, and I agree that antidepressants seem to be handed out quite frequently, but yes, GPs are definitely qualified to diagnose depression, and they are just as qualified to hand out anti-depressants.
I do disagree in you thinking depression is overdiagnosed (well, you didn't say that, but you implied it). Depression, in fact, is greatly UNDERdiagnosed and it is a lot more prevalent in the population than you think. There are many more things to the diagnosis of depression than just a really crappy mood that has someone wanting to commit suicide. That's one extreme end of the spectrum. There are other examples of depression which can be something as simple as a 21 year old guy not eating.
Things that are characteristics of depression include:
psychomotor agitation or depression
loss of appetite
oversleeping or undersleeping
loss of interest in previously enjoyed activities (anhedonia)
thoughts of, or attempts at suicide
etc. etc. etc.
So as you can see, depression can take on many forms. The problem with it is that a lot of people would rather find some other explanation for their symptoms because they don't want to be labelled as a psych patient. There is unfortunately still a stigma in our society when it comes to psych problems.
BTW, about the 12 year old child being prescribed an SSRI....you're right, the FDA hasn't approved it yet, and a recent study in a British Medical journal mentioned that SSRIs shouldn't be prescribed to children under the age of 18, there is much observational data that SSRIs can be used in certain isolated cases with success.
Oh..and ANOTHER BTW, what did your febrile illness end up being?