Roadblocks to Seeking Depression Treatment

You’d be shocked if you learned that most heart disease or diabetes patients go without treatment, but that’s exactly what’s happening to people with depression.

A new Kaiser Permanente study found that a little over a third of patients (35.7%) start treatment after a depression diagnosis.

Those numbers are troubling. Even though many aspects of depression still aren’t fully understood, what we do know is that treatment can be effective for managing depression.

There are plenty of roadblocks that can stand in the way of treatment. However, it’s how you navigate around them that’s critical.

Depression Stigma

Although the stigma associated with mental illness has certainly declined over the last couple of decades, it’s still a barrier to treatment, says Kevin Chapman, Ph.D., a licensed psychologist in Louisville, Kentucky. People may be fearful of what family members will think of them or of employment discrimination, for example.

How to Navigate Around the Roadblock

First, keep in mind that you are not alone in your struggle with depression – 16.2 million American adults have had at least one major depressive episode, according to the National Institute of Mental Health. “Depression is one of the most pervasive types of mental health problems in the United States,” said Dr. Chapman.

Connecting to a community – such as the Anxiety and Depression Association of America’s online support group– can give you a place to turn when you feel overwhelmed. Plus, hearing about other people’s success stories may encourage you to seek treatment yourself.

Cost of Depression Treatment

Financial concerns, a lack of insurance or inadequate coverage, or simply being unable to take time off work can all prevent people from seeking treatment for their depression.

 How to Navigate Around the Roadblock

Low-cost options, both for therapy and medication, are available; you may need to do a bit of digging to find appropriate resources. Federally funded health centers, which have a “pay what you can afford” model based on income, are a great place to start.

If you decide with your doctor to take medication, you can check out Partnership for Prescription Assistance, which can connect you with programs that provide free or inexpensive antidepressants and other medications.

Depression Denial

Denial can be a powerful deterrent to seeking treatment for depression. Some people may want to believe there are other reasons such as stress, lack of sleep or relationship issues for how they feel. However, these reasons may actually be symptoms of the deeper issue.

Living with denial may cause the person to resist seeking treatment for their depression.

“One of the characteristics of the disorder is a lack of motivation and decision making, which gets in the way of seeking treatment,” said Leonard Doerfler, Ph.D., an adjunct professor of psychology at the University of Massachusetts Medical School.

How to Navigate Around the Roadblock

First, the person must acknowledge they are depressed and want to seek treatment. You can’t do it for them.

If the person agrees that he or she is depressed and feels it’s too challenging to get out of the house for therapy sessions, consider video or “tele-therapy” sessions. Some places to start are Amwell ($199 for the first session with a board certified psychiatrist or $99 for a PhD therapist) or BetterHelp ($35 to $80 per week for unlimited access to a counselor).

“There’s some research that shows that using a video conferencing system seems to be just as effective as being physically in the same room,” said Dr. Doerfler.

Increasingly, private insurance is beginning to cover tele-psychiatry or counseling sessions; you can check with your provider.  Additionally, Medicare and Medicaid have covered some telehealth sessions for over a decade.

Cultural or Religious Issues

The Kaiser Permanente study found that Asians, non-Hispanic blacks, and Hispanics are less likely to get treatment for depression than non-Hispanic whites.

“The stigma surrounding depression is even more pronounced in ethnic minorities,” said Dr. Chapman. “Many people are encouraged to seek pastoral care or kin support as opposed to saying something is wrong inside of your brain and you need professional treatment.”

How to Navigate Around the Roadblock

Don’t take it personally if friends or family are unsupportive – there are others from whom you can seek support.

As with the “overcoming stigma” roadblock, connecting with a support group – either in person or online – can help. Often, these groups have people who understand what you are going through and who you can turn to when you need encouragement or advice.

Shortage of Psychiatrists

The United States is dealing with a serious psychiatrist shortage: there simply aren’t enough providers available. The problem is especially dire in rural areas, and some people wait months to get an appointment or must travel far to reach a psychiatrist.

How to Navigate Around the Roadblock

This is another time when it’s smart to turn to telemedicine, including videoconferencing. These days, it’s possible to have initial evaluations, receive full therapy sessions, and have your medication managed — all over the phone.

Depression Treatment Options

There’s not one right way to manage depression. If you’re putting off treatment because you don’t like the solution that your doctor provided, ask for other options – or seek out a second opinion.

“Two-thirds of people who receive either the right medication or a form of counseling that’s been shown to be effective get some real benefits,” said Dr. Doerfler.

The efficacy of specific therapies varies and depends on the individual, of course, but the bottom line is that, for many people, treatment is better than no treatment. Even if your depression currently feels unmanageable, it doesn’t need to be that way.

“You don’t have to suffer in silence,” said Dr. Chapman. “Hope is most certainly available.”

If you are interested in learning more on this topic, please read more here:

“<https://genesight.com/blog/patient/severe-depression-could-hallucinogens-help/”>How pharmacogenomics can help patients with treatment resistant depression” or “How your body metabolizes antidepressants and the role your genes play.”