A Difficult Decision: Impact of Depression

Do you live, focus and act in the present or do you just go through the motions?

How about the way you make decisions – intentional or on the fly?

I will suppose that the majority of us receive a lot of subjective information from each patient. You may have special intake forms. You also probably use patient reported outcome measures.  You ask a variety of questions in order to help with diagnosis or with treatment decisions.

The question I am contemplating: do you consider all of the details you learn about your patient? I’m interested in honing in on questions that screen for depression.


When you ask about depression, what is the reason? Are you screening to know the patient has a psychosocial factor that will affect your outcomes? Are you screening to determine the risk of the patient’s condition becoming chronic? Are you screening because you care? Do you screen for all of those reasons?

Let’s say a patient is depressed. If you see the box checked that indicates depression, then what? Do you go into, “nice to know” mode or do you become curious? What do you do once you know this information?

Asking questions about depression can open a whole can of worms, if you plan on making intentional decisions. I am thinking back to a young 16 year old who indicated depression – along with frequent headaches, other bodily aches and pains and a moderate fatigue level. Although those boxes were checked, from my perspective, I intentionally decided that I needed more detailed information. How did her depression feel? Which then led to needing to know if she ever thought about harming herself. And then, I was shut down by her parent. Her parent became very verbally defensive and shut down my line of questioning.

Since the young lady indicated she frequently thought of harming herself, I had no further information about how she thought of harming herself. I had no way of knowing if she was suicidal. Her parent mentioned the young lady was receiving professional services. No medications were listed, just supplements. I had no idea if the professional services and supplements were helpful.

Intentional decisions are difficult. A defensive parent created an obstacle for my ability to learn about the 16 year old. What do I do? Let it go and keep in mind the young lady reported depression or do more? Based on her checked boxes and her verbal information that she frequently thought of harming herself, I know that she has clinical depression that doesn’t seem to be treated adequately. It is at this point in time that what I do next determines whether I made an intentional decision or just went through the motions of doing my job.

Living, focusing and acting in the moment versus just going through the motions takes effort. Making intentional decisions takes time and care.  It may take extra time, research and communication with professionals outside of the physiotherapy profession.

Do you intentionally practice or do you go through the motions to get through your day?

Until next time,