Rationale:
Patients with mild depression, and many with moderate depression, can benefit significantly from support provided by their general practitioner and other primary healthcare services. These patients often need help processing events, organizing their problems, and understanding depression. Guidance to counteract passivity and avoidance is crucial. Factors such as social isolation, loneliness, and functional impairment due to other illnesses may contribute to the depressive state. Addressing this can alleviate symptoms. Conveying hope and offering practical support to change unhelpful thought and behavior patterns are essential. Antidepressants should generally be avoided until psychotherapy has been attempted.
References:
- Helsedirektoratet, Nasjonale retningslinjer for diagnostisering og behandling av voksne med depresjon i primær- og spesialisthelsetjenesten, IS 1561.
- Barbui C, Cipriani A, Patel V, Ayuso-Mateos JL, van Ommeren M. Efficacy of antidepressants and benzodiazepines in minor depression: systematic review and meta-analysis. Br J Psychiatry 2011; 198(1):11–6.
- Fournier JC, Derubeis RJ, Hollon SD, Dimidjian S,Amsterdam JD, Shelton RC, Fawcett J. Antidepressant drug effects and depression severity. JAMA 2010; 303,47–53. doi: 10.1001/jama.2009.1943.