What can Doctors do when faced with a depressed patient?

Here is a moving exerpt from NHS Blog Doctor‘s weekly casebook:

“I had the St John’s Wort/cow dung conversation today. Again. A rather sad woman who is not coping at work. She is not clinically depressed. She has a rotten boss, an indifferent husband and a very difficult teenage daughter. (Are any teenage daughters not difficult?).

But I am “not a tablet person, doctor” she says. She has been taking St John’s Wart to try to help. St John’s Wort comes as tablets.

“Ah yes, but they are natural” she says.

“Like cow dung and deadly nightshade?” I ask.

She does not get it. They never do. So we chat. And I ask her about her husband and she starts crying. He is having an affair. She knows. He does not know she knows.

She is lonely. Surrounded by people but lonely. This sort of loneliness is even worse than the loneliness experienced by people who are alone. Is it a medical problem? I don’t know. I would like to phone the vicar really, but she does not “do” vicars.

I suggest that she goes to Relate. She would. Gladly. But he would not.

I have nothing to give her but a little time, and not enough of that.”

This particular case stuck out starkly to me as a poignant reminder of how few effective resources are currently available to a GP faced with someone who is clearly not getting their emotional needs fulfilled and is in need of support to get them met – and I thank NHS Blog Doctor for this much needed inside view.
Posted by: Eleanor


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