General Practice and depression

A range of professionals can help people with depression. For many people their GP (general practitioner) is the first port of call when seeking help. GPs can prescribe medication, refer you to primary care counselling and psychology services or to a psychiatrist, sign you off work, and some have good counselling skills.

GPs vary greatly in their abilities to help people with depression. People who thought that they had a good GP often said that they had been lucky. Highly regarded GPs had one or more of the following qualities'

  • They recognised and acknowledged the experience of depression, and so helped patients feel that their distress was legitimate and they were not alone  
  • They demonstrated an understanding of what it felt like to be depressed. For instance, one man was surprised his GP (in his fifties) knew what being a depressed teenager was like!  
  • They connected at a human level with their patients. For instance, one woman said her doctor “makes you feel that it's you he wants to see, never mind the other people waiting… He knows exactly who you are and what you've gone through”
  • They demonstrated a high level of availability and care. Some showed care by being very proactive in encouraging severely depressed patients to make and attend appointments
  • They reassured patients that they would recover in time, but not immediately
  • They listened and made an effort to understand the perspective of patients, even when there were conflicting accounts of the patient's behaviour
  • They gave priority to patients with depression, providing additional time for candid discussion that seemed relatively unrushed
  • They encourage patients with chronic depression to become informed and then treat them like 'expert patients' - i.e. people with a long-term health problem who can understand and manage their own condition themselves (see Expert Patient Programme)
  • They referred patients to specialists when they could not manage the depression on their own
  • They explained about the possible side effects of medication and involved the patient in decisions about their care

People had problems, however, even with very helpful GPs. Being on very familiar terms with a GP can make it harder for some people to discuss difficult issues, such as feelings of despair and suicide. For instance, one female health professional initially pretended she was coping (her GP was also a friend) before her facade crumbled. Some people with depression can find it difficult to deal with the extra attention of a caring GP. And it was thought that even very good GPs can wait too long to refer people to a psychiatrist. Along with the delay in medication taking effect, the time taken for referral can mean many months of distress.

While many people we talked to had an adequate GP, some GPs were considered less skilled in helping depressed people. Some GPs were said to have trouble communicating with patients. One young woman felt patronised by her doctors. As one older man pointed out, some GPs had little understanding of depression, and in some pockets of the UK it was thought GP understanding of depression could be particularly limited. One female health professional felt that it is difficult to negotiate with GPs when you have depression because you lack confidence, and depression is not visible. She suggested bringing someone else to the consultation to support you, or writing everything down first.

There were many stories about GPs who failed to recognise or diagnose depression. A number of people lived with depression for many years without receiving an adequate explanation from their GPs.

Even knowledgeable GPs could fail to communicate about depression in a manner that patients understood. For instance, one woman only found out she had an earlier diagnosis of depression during a subsequent episode.

Last reviewed September 2017.

Last updated October 2012.


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