Depression in Older Adults 12/7/2017

Depression is not an inevitable part of growing older, but there are factors that come with aging that can increase the risk of developing depression, even for a person who does not have a history of depression. These include retiring and losing one’s professional identity, increased medical problems, losing loved ones, and increased isolation. It […]

Is it Menopause or Depression? 2/15/2018

Is it Menopause or Depression? Females in their 40s and 50s often present to their primary care providers with new-onset depressive symptoms. In developing a treatment plan, it is important to assess if the symptoms are part of menopause or perimenopause or if they represent a new-onset depressive disorder. A complicating factor is that menopause […]

Maximizing Efficacy of Antidepressants

Antidepressant medications, most commonly the selective serotonin reuptake inhibitors (SSRIs), are frequently prescribed by primary care providers for depression, anxiety, and impulse control disorders. There are some important guiding principles to keep in mind when prescribing these medications, which can dramatically improve a patient’s response to treatment and ensure ongoing safety. Here is a review […]

Treating Co-Morbid Depression and Coronary Artery Disease

Coronary artery disease is the leading cause of death in the United States and is one of the main contributors for the global burden of disease. One in four patients with coronary artery disease also suffer from depression, which adds to the risk of recurrent myocardial infarction and death. Guidelines exist to urge primary care […]

Medical Differential for Patient Presenting with Depressive Symptoms

When a patient, especially one without a history of depression, presents with depressive symptoms, it is important to consider if those symptoms are a result of another medical condition. Depressive symptoms that are more likely to be in this category include:  Fatigue/low energy  Trouble initiating or maintaining sleep  Hypersomnia  Significant change in […]

Breaking Confidentiality with Confidence

While privacy and confidentiality issues are paramount parameters in all healthcare interactions, it is not uncommon for providers to feel constrained at critical moments by these concerns. A recent consult received on our provider triage line [(858) 880-6405] involved a single, middle aged gentleman who had presented on his own steam to a clinic with […]

Depression in Adolescents

Major depression affects 6% of adolescents with an additional 5-10% presenting with sub-syndromal symptoms of depression. There is a 2:1 female:male ratio of major depression in adolescents. Teens frequently don’t present with the typical DSM criteria for Major Depressive Disorder (MDD). Common depressive symptoms in adolescents include: irritability (as opposed to reporting a sad mood), […]

Depression related to pregnancy

Depression related to pregnancy is a common and potentially serious concern for both mom and the baby. It is therefore important to understand the various conditions and when it is important to have a clinical intervention. Postpartum Blues: Symptoms of mood lability, irritable mood, interpersonal hypersensitivity and tearfulness are common in the postpartum period and […]

Depression in Older Patients

Depression can occur in any patients as they age, even without a prior history of depression. Older individuals can present with mood symptoms that can seem to be part of the normal aging process, but it is important to assess for the possibility of a masked depression. Of note, there is an increased risk of […]

Treating Depression in Older Patients PART 2

In last week’s eWeekly article, we discussed the features to be aware of in evaluations of depression in older patients, including the influence of depression and/or cognitive impairment in increasing the risk of the other condition. This eWeekly addresses treatment of depression in older patients and how it might differ from treatment in younger adults. […]