Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 7/26/2021
So you think you have depression, and you’ve decided to seek help for it. Congratulations! That’s the hardest step.
Taking that step has probably led you to one of the most frequently asked questions about getting treated: where do you start? Who’s the depression doctor you need?
There are a couple of common-sense answers the average person might assume are true.
You could start by seeking out a therapist or psychiatrist, or by speaking with your healthcare provider.
If you ask three different people, you’re likely to get three different answers. And all of them might be correct.
The truth is, the answer is likely to be quite different for each person. We’ll get to the reasons why in a moment, but first, it’s helpful to understand some things about depression and severe depression and how they’re treated.
According to the National Institute of Mental Health (NIMH) clinical depression is a mood disorder characterized by continuing patterns of feeling empty inside, down, sad or by losing interest in daily activities.
If those negative thoughts are strong enough to affect your daily life and responsibilities, you may have depression.
There are several types of depression. Some, like Seasonal Affective Disorder (SAD), happen during specific times of the year and are related to weather.
Others, like major depression or bipolar disorder, are extreme and can affect all facets of a person’s life (e.g. sleeping, working, eating, etc.).
In contrast to major depression, persistent depressive disorder can last two years or even longer. Depressive disorder often takes a multitude of different treatments, which may change over time as your symptoms evolve.
Basically, there are many signs of depression, and learning to recognize them can help you figure out if you’re suffering from something like mild depression, moderate depression or severe depression.
Functionally, depression is the result of imbalances in serotonin and other neurotransmitters in your brain that cause emotional distress.
Symptoms of depression may include a variety of mood issues like anger, exhaustion or irritability. There are also physical symptoms of depression, like stomach issues.
It’s unclear why people become depressed — there doesn’t appear to be a single answer.
Some research suggests biological, genetic or psychological may impact or increase the risk for depression or experiencing depressive episodes.
It is also believed that environmental factors like traumatic experiences, certain life events, career and relationship issues, etc. can also prompt depression or depressive episodes.
What we do know, however, is that left untreated, depression can lead to things like sleep issues, reckless behavior, substance abuse and, in some cases, suicidal thoughts or actions.
People with depression are generally treated with a variety of therapies, including medication, lifestyle modifications and various forms of psychotherapy.
There are many forms of therapy, but when it comes to depression, the most popular and well-known form is Cognitive Behavioral Therapy (CBT).
The purpose of CBT, also called cognitive therapy, is to help you recognize (and eventually gain control of) unhealthy or negative thought and behavior problems.
A healthcare professional may combine several of these treatments, as well as recommend things like changes to your diet or even lifestyle things like incorporating mindful meditation into your daily routine.
There are some easy answers about why you may want to start treating your mental health conditions with your regular healthcare provider, and the first is comfort.
Someone who has been treating you for years will have a better idea of your unique needs and circumstances, and will be able to make a well-informed next decision, which could be handing you a referral to a psychiatrist, or a prescription for medication.
Your healthcare provider is best suited to make referrals, and will be able to give further specialists like a therapist important information about your health that may be necessary for treatment.
There’s actually a reason to talk with your regular healthcare provider first (beyond getting a referral), and that’s the consideration of physiological factors in your depression.
Depression risk can be elevated by poor diet, poor health and insufficient exercise, as well as lifestyle issues like insufficient sunlight or substance abuse.
Talking to a healthcare professional will help you screen for depression, which may give you time to minimize and possibly eliminate their impacts on your mental health conditions.
Improving your overall physical health with an exercise regimen, for instance, has been shown in some cases to be as effective as drugs in treating depression.
On the other hand, there are plenty of reasons to start with a mental health professional like a psychiatrist or therapist right away.
Some of these are psychological — you may want to begin treatment with a clean slate, or with someone you don’t already have a rapport with.
But more importantly, a therapist offers immediate access to specialized skills for treatment.
Starting with a therapist or psychiatrist allows you to begin therapy immediately, voicing your concerns and problems and introducing yourself with a focus on what you want to address.
This initial assessment will set you up for what your depression therapy sessions will look like in the future, whether you meet once a week or more or less often, depending on your needs.
And while a healthcare professional may only spend a few minutes on your mental health during a checkup, a therapist will give you the entire session of between 30 and 50 minutes.
And therapy may also give you the space to work on some relationships, because it can be done with other people.
While both psychiatry practitioners and general healthcare providers will be able to prescribe you medication, the regularity of therapy visits will give you a more effective way of judging the medicine’s effectiveness, as you’ll be meeting regularly to discuss progress over months or even years.
Therapists will also help you set your own goals based on what you’ve asked for help with.
Ultimately, whether you choose to talk to your healthcare provider or a psychiatrist first doesn’t matter. What matters is that you make peace with the idea that getting help isn’t a sign of weakness, and that you talk to someone immediately.
The right doctor for depression is the person you go to first.
Doing the treatment of depression “right” is important, but getting caught up in the anxiety of decision making at the expense of actually receiving help is just as bad as not seeking treatment.
The right person to talk to is who you feel comfortable talking to. If that’s your healthcare provider, they will be able to help guide you along the treatment path.
If it’s a psychiatrist, they will be able to help you understand your condition better and be there to help you regain control.
And yes, both will be able to prescribe medication.
If you’re still trying to determine whether you have depression or not, we can help you understand more about it. Learn more about depression symptoms, and consider taking a look at our “Am I Depressed” Checklist to see if you meet the criteria.
Either way, the best treatment for depression can make all the difference, and it isn’t learning in isolation: it’s seeking support.
If you’re looking to talk to someone immediately, you have the option to explore our online psychiatry options for virtual support in your healing journey.
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