The U.S. Preventive Services Task Force reached a significant development in the diagnosis and treatment of depression last January. Recommendations from a 17-member task force comprised of scholars and practitioners in the mental health field, suggest that Primary Care Physicians screen all adults for symptoms of depression. The task force advises doctors to pay special attention to pregnant and postpartum women, as a mother’s depression has a significant effect on her newborn child. In the report, published in the Journal of the American Medical Association on January 26, 2016, there is a section titled “Screening Tests” which includes the following recommended guidelines for screening adults for symptoms of depression:
“Commonly used depression screening instruments include the Patient Health Questionnaire (PHQ) in various forms and the Hospital Anxiety and Depression Scales in adults, the Geriatric Depression Scale in older adults, and the Edinburgh Postnatal Depression Scale (EPDS) in postpartum and pregnant women. All positive screening results should lead to additional assessment that considers severity of depression and co morbid psychological problems (eg, anxiety, panic attacks, or substance abuse), alternate diagnoses, and medical conditions.” (see U.S. Preventive Services Final Recommendation).
Once physicians determine that their patient is exhibiting symptoms of depression, they are advised to prescribe anti-depressants and refer out for psychotherapy.
As a therapist who works with depressed patients, this news offers encouragement that more persons who are suffering with this illness will be treated effectively. However, as a therapist who also works with patients diagnosed with Bipolar Disorder, these suggestions are a cause for concern that many people suffering from Bipolar Disorder might be improperly diagnosed with Unipolar Depression.
Why is this important? Studies have shown that persons with Bipolar Disorder should avoid using antidepressants, because it can induce mania:
“The treatment for bipolar depression is different than for regular depression. In fact, antidepressants can actually make bipolar disorder worse or trigger a manic episode. Try mood stabilizers first and never take antidepressants without them, as antidepressants can trigger mania and rapid mood cycling when used on their own.” (see: Bipolar Medication Guide).
As this policy continues to take effect and screening for depression increases, let’s remember best practices to screen for incidents of mania in depressed patients as well. A good tool for ruling out manic and hypomanic episodes is the Mood Disorders Questionnaire that can be found at Stanford Medicine Bipolar Disorder Clinic.
If you would like additional information on treatment for Depression or Bipolar Disorder, please contact me at firstname.lastname@example.org.