Detecting and Treating Depression in Primary Care

On the 5th of August 2021, the ReachOut initiative hosted an online event to discuss Detecting and Treating Depression in Primary Care. The emcee of the night, Sharveena Daniel, started off the session with a brief introduction of the National Coalition for Mental Wellbeing Malaysia and talked about their visions, missions and core values. She also touched on their strategic priorities and key focus areas. Following this introduction, Sharveena invited the moderator for the night, Dr.Sivaneesan, who is the Chairman of the Private Practitioners Section in the Malaysian Medical Association. Dr.Siva has served an impressive 20 years as a doctor and has a special interest in family medicine.

 

Dr.Siva jumped right into the statistics, sharing that 30% of adults and 12% of children, experience mental health problems. He went on to highlight that although there are various forms of mental health issues, the most common one is; depression. Dr.Siva took the liberty of pointing out that general practitioners are the first point of care for most people, however, most of them do not treat much less diagnose, depression. With nearly 8,000 general practitioners available throughout Malaysia, Dr.Siva believes that it would be very easy for community members to reach out and seek advice, help or treatment for not only depression, but other mental health concerns as well.

 

 

Key speaker, Dr.Stephen Jambunathan, a consulting psychiatrist, psychotherapist, and a medical director of the Mind Faculty, was called to give his two cents on the matter. Dr.Stephen was the first Malaysian to do a postgrad overseas training in psychotherapy, at the University of Melbourne in 2001, where he focused on the fields of cognitive behavioural therapy and psychodynamics psychotherapy. He dived into the different ways depressive disorders can manifest and then moved on to the signs and symptoms. He also informed the attendees that depression is now known as the prime global burden disease.

 

 

Dr.Stephen also touched on the different comorbidities that can arise with depression. He  then went on to emphasize the importance of precise diagnoses in primary care. General practitioners should be able to extract as much information from the patients as possible, so that they have an understanding of the bigger picture and are able to connect the dots accurately – as sometimes, depression can mimic other conditions. “Are we looking closely enough for symptoms of depression and anxiety in patients?” Dr.Stephen, asked. He also talked about suicide in relation to depression; how one can be assessed for suicide risk, risk factors of suicide and the different severities of suicidal attempts.

 


 

The aims of the various depressive disorder treatments were also discussed in length and management strategies were provided and explained. Treatment resistance was also brought up for the knowledge of the attendees. Following Dr.Stephen’s insightful talk, was a Q&A session. The attendees asked relevant questions such as: How do you overcome the challenges of not having parameters in primary care when monitoring depression? Why does positive motivation cause more harm to depressed individuals? What could be the cause of depressive moods during the lockdowns we are all facing?

The informative session ended with a gentle reminder that people need to be aware of these issues so that they can not only help themselves if they need it but can also spot the symptoms and warning signs in their friends and loved ones.

 

 

Ending the session, emcee Sharveena provided a list of nine carelines that attendees could take note of and share if professional assistance or care were required.

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