Section C: Using Mental Health Services

START WITH A PHYSICAL EXAMINATION The first step to getting appropriate treatment for depression is a physical examination by a physician. Certain medications and some medical conditions, such as a viral infection, can cause the same symptoms as depression. The physician should rule out these possibilities through examination, interview, and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation should be done by the physician or by referral to a psychiatrist or psychologist.

REFERRAL TO MENTAL HEALTH EVALUATION AND ASSESSMENT: A good diagnostic evaluation will include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before, and, if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective. Last, a diagnostic evaluation should include a mental status examination to determine if speech, thought patterns, or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness. Treatment choice will depend on the outcome of the evaluation.

RECOGNIZE THE MOST COMMON PROBLEMS Mental and behavioral health problems fall into many categories, including adjustment problems, anxiety disorders, mood disorders (depression), post-traumatic stress disorder (PTSD), developmental disorders, behavioral or conduct disorders, feeding and eating disorders, elimination disorders, sleep disorders, substance use disorders, personality disorders, and psychotic disorders. (References from the https://kidsmentalhealthinfo.com/)

A neuropsychological evaluation, also called neuropsychological testing or a neuropsych for short, is an in-depth assessment of skills and abilities linked to brain function. The evaluation measures such areas as attention, problem solving, memory, language, I.Q., visual-spatial skills, academic skills, and social-emotional functioning. A neuropsychological evaluation is different from tests included in a neurological evaluation (e.g., EEG) or neuroimaging (e.g., CT or MRI scan).
They are not easy to get in Alaska because they need to be administered by a trained licensed psychologist. The purpose of a neuropsychological evaluation is to understand how medical conditions involving the brain or central nervous system affect the person’s development, including impacts on cognitive, emotional and behavioral functioning.

There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders. Some people with milder forms may do well with psychotherapy alone. People with moderate to severe depression most often benefit from antidepressants. Most do best with combined treatment: medication for relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depression. Depending on the patient's diagnosis and the severity of symptoms, the therapist may prescribe medication.