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How to manage depression in the busy professional

There has been a definite increase in General Practice mental health presentations in our society. The most apparently competent and successful career people can also be the most exhausted and over-extended in many areas of their lives. What makes some people cope better than others, and what makes someone decide they cannot cope any more without help?

Dr Jon-Paul Khoo, a psychiatrist with a special interest in depression, reminds us that we need to appreciate the mental health vulnerability of the person in front of us, especially in the context of work and family life. This means discussing the patient’s family history of mental illness, their social and family support, their work ethic and the consequent potential stigma of them not coping in their job.

Drugs and/or alcohol may be either the cause or the result of depression. The difference is important. Dr Khoo notes that assessment of suicidal potential and issues relating to the prescription of any potentially addictive medication, even in the short term, is paramount. GPs should always remember that a patient may not be honest about how bad their private habits are really getting.

The concept of burnout versus a depression that needs medication is also important. Dr Khoo – who is giving a lecture on Depression in the Busy Professional at the upcoming 2019 General Practice Education Day in Sydney next month – will discuss how to differentiate between the two, and when the former is morphing into the latter. If depression is diagnosed, the management is likely to be more complex and drawn out, and consequently will need greater medical supervision.

Are there treatments that selectively promote cognitive symptom recovery in patients with depression? What are the best medication options for true depressive illness occurring in the busy professional? Dr Khoo will also explore these questions at the Sydney seminar, along with non-pharmacological therapies, vocational training, privacy and confidentiality, returning your patient to work, and when to refer to a psychiatrist.

Dr Jon-Paul Khoo will share more expert advice on the management of depression in busy professionals at the Sydney General Practice Education Day 2019. This will take place at ICC Sydney on 24 August.