Further, research has shown that depression medication and psychotherapy together are more effective for treating depression than either approach alone.

If general practitioners lack the time and expertise to treat depression properly — and if they are not compensated enough for it under managed care — why do they provide most of the treatment for depression?

"Many of my patients want me to treat them because they trust me as their family doctor," said Dr. Jim Martin, a family physician in San Antonio. "Some of my patients don't want to see a specialist because of the stigma of depression."

But growing numbers of patients no longer have the choice, he added, because some managed-care plans have begun reducing or even eliminating coverage for general practitioners for treating depression.

Psychiatrists say it is unrealistic to think that mental health professionals can do the job themselves because there are not enough of them to treat the estimated 35 million Americans with depression, only about half of whom receive treatment now.

"Without primary-care physicians, we won't make a dent in treating more people with depression," Dr. Greden said.

His research shows that primary-care physicians improve their ability to diagnose and treat depression when they forge relationships with psychiatrists and psychologists, consulting with them about particular patients. Under this model, primary-care doctors do the medical treatment, but check with the specialists about drug choice and dosing and refer patients to them for talk therapy.

"If general practitioners don't have the wiggle room from managed care to spend more time with patients who are suffering from depression," Dr. Kupfer said, "society will pay a large price in suicides and in high levels of impairment."

Source: NY Times

You can find comprehensive information about depression and treatment for depression in the HealthyPlace.com Depression Center.

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