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If you have been experiencing low mood, anxiety or lack of energy for some time and you live in Spain, the usual thing to do is start with your primary care physician at the health center.
There you will be assessed. They may start you on commonly used antidepressant medication and, if you need it, refer you to mental health services for psychological therapy or more specialised care.
Never self-medicate and always follow the medication leaflet and the instructions of your doctor or pharmacist.
How is depression diagnosed by a family doctor?
The first diagnosis of depression in the public health system is usually made in Primary Care, with the family doctor.
During this initial evaluation, the doctor will ask about your symptoms, medical history, substance use, and personal circumstances, and may use brief questionnaires to assess the severity of your depression. They will also review your physical health to rule out other illnesses that could explain your distress.
With all this information, the doctor assesses whether it is mild, moderate, or severe depression and decides on the next step. In mild cases, the focus may be on self-care guidelines and close monitoring, while in moderate or severe cases, medication, psychotherapy, or both are usually recommended.
What treatment options are there: therapy or antidepressants?
In the public system, the treatment of depression may combine some type of psychological support and pharmacological treatment, depending on the situation of each person.
For mild depression, psychological interventions, psychoeducation, and lifestyle changes are prioritized, reserving antidepressants for when initial measures are insufficient. In moderate or severe depression, clinical guidelines typically recommend combining antidepressants and therapy.
The primary care physician can start treatment with common antidepressants, such as selective serotonin reuptake inhibitors, and monitor progress in the office.
At the same time, you can request a referral to a mental health center for individual or group therapy, depending on the services offered in your region. It is important not to stop or adjust the dosage on your own and to consult with professionals about any adverse effects.
What role do the psychologist and psychiatrist play in your treatment?
When the case is complex, there is a risk of suicide, or you don't improve with initial treatments, the doctor usually refers you to a mental health center. There, a clinical psychologist and a psychiatrist work together.
The psychologist focuses on psychotherapy, applying techniques such as cognitive behavioral therapy or behavioral activation to help you manage the thoughts and behaviors that maintain depression.
The psychiatrist is mainly responsible for making a detailed diagnosisdetailed diagnosis, adjusting your medication, and considering hospital admission or more intensive support if necessary. Throughout the process, you may move from one level of care to another depending on how you are doing.
The key is to seek help as soon as possible if you suspect you have depression, maintain open communication with your mental health team, and always follow the recommendations of your doctor, psychologist, and pharmacist, as well as the information in the package leaflet for each medication.
