Diagnosis and treatment

If your symptoms persist, make an appointment with your GP or if you feel more comfortable, arrange to see one of the practice nurses. Take someone with you for support who you trust or as a second pair of ears to take note of what is discussed and agreed during the consultation.

To help make the most of the consultation and provide a clear view of what is happening to you:

• make a list of all your symptoms, whether they are worse at certain times of the day or on particular occasions, how long you’ve had them and their effect on your day-to-day life and relationship with others
• explain any circumstances that could be contributing to these symptoms and the way you feel
• take a list of all medications you currently take, including any supplements or non-prescription medication
• Be as open and honest as you can; remember anything you say is confidential.

You should be asked how you’ve been feeling, for how long and how it is affecting you on a day-to-day basis.

Any physical symptoms you describe may need further investigation but if no reason for them is found, don’t be put off if the GP seems unhelpful or feels nothing more can be done to help you.

If your symptoms have lasted more than a month, depression is a diagnosis that should be considered. Your age on its own should not be seen as the cause of your problems and should not decide the type of treatment you are offered.

Treatment

In October 2009, NICE (The National Institute for health and Clinical Excellence) issued guidance on:

• ‘Treating depression in adults’ and
• ‘Treating depression in adults with long-term physical health problems’.

The guidance covers diagnosis, treatments options that should be available on the NHS for mild, moderate and severe depression and how to stay well in the future. It also suggests questions you may like to ask about your treatment and how family and friends can help in supporting you.

Patient versions of this guidance are available on request or can be downloaded from the NICE website. You can find out how to do this in the Further information section.

There are several treatments available for depression depending on the severity of your symptoms:

• advice from your GP or nurse at the practice on managing or coping with symptoms, with the offer of a review within 2 weeks to see if they are helping and how you are
• joining a physical activity programme that takes account of any health problems you have. Regular exercise is known to improve mood and sense of wellbeing as well as improving physical health
• joining a peer support group - an opportunity for you to meet with others who have the same condition so you can share your experiences and solutions
• psychological therapies (talking therapies) such as counselling or cognitive behaviour therapy
• anti-depressant medication
• assessment and support from a member of the community mental health team or local older persons mental health team.

You may find there is awaiting list for talking therapies in some parts of the country.

In your discussion with your GP ask him to explain:

• which treatments may be appropriate in your case. If your GP favours a particular treatment, ask why?
• how the different treatments work and their benefits and risks
• how soon you can expect to start to feel better
• how long are you likely to need to continue with treatment
• how often you need to come back for a review
• what you can do to help yourself and whether there are any local groups you may find it helpful to contact

You can then discuss your preferences and agree which treatment(s) you should try.

If you are considering talking therapy, be sure to mention any cultural, language or religious needs you have or any hearing or sight problems, so they can be addressed when arranging therapy for you.

If you have a health problem or hearing or sight difficulties that could be contributing to how you feel, make sure you are getting the best possible treatment for those too.

Support from family and friends

It may be helpful, if you agree, for a family member coming along with you to the GP so they can ask any questions about how best to help and support you. It can be weeks before the treatment makes you feel better and so support from family and friends to keep appointments or take medication can be vital to a successful outcome.  Their reassurance that things will get better with time, along with regular phone calls or visits and offers of practical help can all contribute to your recovery.

Keeping well in the future

It is important to do all you can to stay well. Be sure to continue with any prescribed medication. If you are now taking regular exercise, have learned some relaxation techniques, are getting out more and have developed new friendships and interests, keeping them up is important to your long term health and wellbeing.

Should your symptoms seem to be returning, let friends and family know and make an appointment to see your GP so any problems can be nipped in the bud.