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    What if screen is positive?

    Confirm diagnosis by doing a more detailed questionnaire or by referring to a mental health provider
    Rule out differential diagnoses: substance abuse, bereavement, bipolar disorder, hypothyroidism, anemia, and other medical conditions1
     
    Assess all patients with depression for suicidal or homicidal ideation2
     
    Modes of treatment:
    • Lifestyle modifications: exercise, sunlight exposure, stress management, healthy sleep habits
    • Counseling (individual or group)
    • Psychotherapy: consider cognitive-behavioral therapy, interpersonal psychotherapy, psychodynamic therapy, and problem-solving therapy; may be used in combination with pharmacotherapy2
    • Pharmacotherapy with antidepressants2
    • Electroconvulsive therapy (ECT): consider in patients with severe, unresponsive depression2
    • Other therapies: transcranial magnetic stimulation (TMS), light therapy, alternative medications such as St. John’s wort2

     

    The Maternal and Child Health Bureau created a brochure: Women and Depression Across the Lifespan.  The brochure can be ordered by completing the MCH Publications Order Form. 


    References:
    1. Maurer DM. Screening for depression. Am Fam Physician. 2012 Jan 15; 85(2):139-44.
    2. American Psychiatric Association: Practice Guideline for the Treatment of Patients with Major Depressive Disorder, Third Edition, 2010. http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf (Accessed on December 4, 2014).
     

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    12/2014