Assess for Depression
- Chief complaint of sleep disturbance, fatigue, appetite or weight change
- Chronic pain
- Chronic illness(es)
- Recent major stress or loss
- Multiple unexplained symptoms
- History of depression
If your patient has one or more of these red flags ask the patient these two questions:
* During the past month, have you often been bothered by little interest or pleasure in doing things?
* Have you been feeling down, depressed or hopeless?
If your patient answers yes to one or both of these questions ask the patient to complete the PHQ-9 form.
The PHQ-9 is an easy but powerful tool to assist healthcare professionals in providing evidence-based care to their depressed patients. Many healthcare professionals who suspect depression ask the patient to complete the free-of-charge PHQ-9 during a break and simply hand-score it before resuming the visit. The PHQ-9 score gives healthcare professionals a tentative diagnosis, identifying patients who need to begin active treatment for the condition. The PHQ-9 also gives healthcare professionals a severity score to monitor treatment response over time.
Download the PHQ-9 Form
Treatment Recommendations (Printable PDF)
Overview of Treatment for Depression
Query patient about preferred treatment (antidepressant medication or behavioral counseling).
If patient prefers antidepressant medication:
- Select and initiate antidepressant medication
- Educate patients on the rules of antidepressants (distribute attached handout).
Rules of Antidepressants (Printable PDF)
- Antidepressants don't work suddenly. Benefit comes on slowly, may take a few weeks.
- Antidepressants only work if you take them everyday.
- Antidepressants are not addictive.
- Side effects are usually mild and get better with time.
- After you feel better, you must continue to take them for at least four months to reduce the risk of depression returning.
- Call your healthcare professional before discontinuing use.
Overview of Medication for Depression
If patient prefers behavioral counseling*
- Office nurse and patient identify behavioral counseling providers covered under patient's health insurance who are accepting new patients
- Office nurse instructs patient on making an appointment with behavioral counseling provider.
- Office nurse healthcare professional calls patient in two weeks to assure patient has completed referral
- Healthcare provider assesses patient response to behavioral counseling in 12 weeks
- Healthcare provider suggests adding antidepressant medication to patients who do not report a full response to behavioral counseling in 12 weeks.
*Short-term behavioral counseling has been shown to be just as effective as antidepressant medication in treating mild to moderate cases of depression.