Friday, March 7, 2008

Depression: case


A young man visits me at the clinic. He believes he is suffering from depression and would like to have some information on the topic, as well as about various medications, and alternative therapies. He admits that he is hesitant to go on medication, but also realizes that this may be his best option. He would like to be better informed before discussing his situation with his doctor. He has already looked online, but admits that most of what he's read is not particularly trustworthy and would like some advice on better resources.


The first thing I do is show him MedlinePlus. I run a sample search and show him how he can also search the encyclopedia, and the drugs and supplements. It occurs to me that a decision aid might be useful to him, since he is in the process of trying to make a decision. I search the Ottawa health research Institute A-Z Inventory of Patient decision aids and find the Mayo Clinic's Depression guide which includes information on antidepressant meds, complementary and alternative therapies, personal stories and things to consider.

While we are talking it becomes apparent that he is a voracious reader, and quite prepared to actively participate in managing his own health, so I decide to also recommend a couple of books that he might find useful:

The Noonday demon: An atlas of depression, by Andrew Solomon, provides an astute and in depth look at depression through the ages and the controversy. The book is an engrossing read, is well researched, and provides a balanced look at the pros and cons of medication as treatment.

Full catastrophy living: Using the wisdom of your body and mind to face stress, pain and illness, by Jon Kabat-Zin. This book is a companion to the Stress Reduction Clinic at the University of Massachusetts Medical Centre, founded by the author. Yoga and mindfulness meditation are taken out of the realm of spirituality and religion, and used as practical and effective stress, pain and illness management tools. The program can be followed independently using guided yoga and medication tapes.


It feels good to recommend books as well as online resources for a change. I don't often get the chance to do so since most of the questions I get are better answered in a relatively quick and dirty way. Usually people who come to me are looking for immediate and timely answers: information about clinical trials, medications, back exercises, dietary recommendations related to various conditions etc.

Total time: 1 hr

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