Feeling blue, sad, or depressed: how to manage these patients

Many patients present to primary care complaining of feeling blue, sad, or depressed. GPs generally work from a biomedical standpoint using the concept of depression, with medicalisation being the logical result. We believe that GPs are able to adopt a more person-focused approach in which they prioritise the psychosocial above the biological. Here we provide two examples of how GPs could start with this approach in a consultation with a patient who is feeling blue, sad, or depressed. An important element of the proposed approach is only applying a psychiatric diagnosis in selected patients with a high prior chance of serious psychiatric disorder. The high prescription rates for antidepressants1 suggest that GPs work from a biomedical point of view and start questioning the patient about the symptoms of depression listed in the guidelines. GPs commonly report having ‘no other option’ …