When Maria Garay, 48, came in for her regular checkup this summer, she wouldn't have said she was depressed, but after her doctor questioned her about her difficulty sleeping and her mood, she was given a prescription for an antidepressant.
"I wasn't feeling myself. I wasn't enjoying the things I did in the past," says the mother of two who lives in New York. "It didn't surprise me that he said it was depression, but I was reluctant to go on medication at first." After her doctor, Dr. Albert Levy, explained why the drugs might help her cope, she agreed to try them out.
"Often patients don't come in saying, 'I'm depressed,' they come in with an incredible amount of different signs -- headaches, trouble sleeping, for instance -- but a deeper consultation will reveal that they are," says Levy, an assistant professor of Medicine Mount Sinai School of Medicine. Now Garay sees Levy once every few weeks to check in, manage her symptoms, and discuss any issues, Levy says. According to Garay, the medication has "helped tremendously."
Levy is one of many family doctors that are taking on the role of therapist with their patients.
According to new survey data from the Centers for Disease Control and Prevention, one in 10 Americans older than 12 are now taking antidepressants -- a fourfold increase in the prevalence of antidepressant use since the late 1980s.
While antidepressant use is on the rise, it's not always mental health professionals that are writing the scripts: less than one third of patients on antidepressants reported seeing a mental health professional within the past year.
The report, published Wednesday, draws on a survey of over 12,000 Americans over the age of 12. Women Garay's age were the largest consumers of antidepressants: 23 percent of all women ages 40 to 59 reported taking antidepressants.
While the idea of primary doctor handing out antidepressants without a therapist's consultation may seem alarming, many psychiatrists felt that screening for and treating depression in your doctor's office was a necessary expansion of a PCP's duties.
"The reality is that there are not enough mental health care providers around to treat all who need it," says Dr. Gary Small, a psychiatrist and director of the UCLA Center on Aging. "Part of what we do as psychiatrists is teach doctors how to diagnose and treat depression so that a lot of depression can be handled in primary care."
"It's a required part of training in our specialty [to treat depression]," says Dr. Lee Green, professor of family medicine at the University of Michigan. "We refer patients with the most complex or treatment-resistant depression to psychiatrists for medication management, but that is only a minority of people with depression. Most patients can, and should, get their antidepressant prescription from their family doctor," he says.