Why People with Depression Hide Their Symptoms from Doctors

If you felt depressed, would you tell your doctor during your next appointment? Most people say no. That question and its answer are being discussed among mental health professionals across the country. The National Institute of Mental Health recently funded a survey and analysis designed to determine the reasons that patients do not talk more frequently with their doctors about depression. The survey was conducted by phone and included interviews with over 1,000 adults in the state of California. During the phone interview, participants were asked questions relating to their overall health and access to health care and insurance; questions pertaining to demographics; and queries dealing with personal or family mental health history. When asked more specifically about sharing/not sharing possible depression with their primary care giver, respondents were provided 11 possible reasons for not doing so and were asked if these reasons applied to them not at all, a little or a lot. The survey revealed that 43 percent of those polled would not share symptoms of depression with their doctor during a normal office visit. Reasons for avoiding sharing symptoms varied. Anti-Medication Sentiment and Stigma Top List By far the greatest number of respondents (23 percent chose “a lot”) said they would not talk about their depressive symptoms with their doctor because they feared receiving a prescription for anti-depressant drugs. This strong anti-medication sentiment was followed by a belief that mental health was not a realm regularly addressed by general practitioners (16 percent) and fears that somehow medical records of depression would come to be known by employers or others (15 percent). A Yale psychiatry professor commenting on the study wondered if the statistics might be even slightly worse (in terms of willingness to reveal) had the survey been conducted in a state besides California. The statistics do reveal that there remains a perceived stigma attached to mental health problems and that stigma presents an obstacle to receiving proper care. After all, treatment of depression necessitates self-disclosure on the part of the patient. Though patients may be uncomfortable bringing up mental health concerns with their physician, not doing so can result in significant problems down the road. Medical research increasingly reveals that depression can actually cause harm to the brain. And the longer depression persists, the more difficult it is to treat effectively. Unfortunately, this study showed that those who reported symptoms of moderate to severe depression were more likely to be opposed to self-disclosure with their doctor. Reducing the Stigma of Depression There are things that can be done to try and turn the situation around. There is a public service announcement in development which may help to inform the most at risk population about depression and its treatment. Additionally, primary care physicians can stock waiting rooms and exam rooms with pamphlets and brochures explaining the condition and suggesting patients share symptoms with their doctor. Adding a questionnaire about symptoms to part of the normal medical regimen may also help doctors identify depression and overcome reluctance to talk. There are people suffering with depression who aren’t telling their doctor. Finding ways to reassure people that their general practitioner is able and ready to discreetly help them could go a long way toward changing current negative attitudes and fears regarding depression.