- With Mayo Clinic psychiatrist
Gabrielle J. Melin, M.D.
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Gabrielle J. Melin, M.D.
Gabrielle J. Melin, M.D.
Dr. Gabrielle Melin, board certified in general psychiatry and psychosomatic medicine, is looking for ways to empower patients and families dealing with chronic mental illness. She encourages patients to commit to working together with their physicians and health care teams.
Dr. Melin completed medical school at the University of Minnesota. She completed both her psychiatry residency and consultation-liaison fellowship at Mayo Clinic before joining the Mayo Clinic staff in 2001. She is medical director of Mayo Clinic Psychiatry Emergency Services in Rochester, Minn. She has special interests in emergency psychiatry, adult psychiatry and addiction psychiatry.
"Instilling hope is one of the most important things we can do for patients and families. Mental illness can be chronic and significantly impacts lives. Our goal is to provide the best treatment and education so that patients can manage their symptoms more effectively," she said.
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Depression blog
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Feb. 3, 2009
Depression treatment: Monitor how well treatment is working
By Gabrielle J. Melin, M.D.
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The goal of depression treatment is to reduce or eliminate your symptoms. While medications and therapy can be effective, symptoms may persist. The severity of the symptoms remaining after treatment may range from mild to severe. These continuing symptoms might be caused by:
- Other medical illnesses
- Chronic pain
- Substance abuse or addiction
- Personality disorders which are untreated or unrecognized
- Not following your health provider's depression treatment recommendations
It's not uncommon for depression to recur after your treatment. So, it's important to measure how well your treatment is working. I've talked about using the Patient Health Questionnaire-9 (PHQ-9). This is a questionnaire (it has nine questions) you can fill out that helps you determine how depressed you are, which in turn can help you gauge how well your depression treatment is working. This assessment is based on reliable data taken from the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions.
The PHQ-9 can be administered over time (like a blood pressure measurement) to monitor your depression treatment progress. I've included a link at the bottom of this posting to a depression self assessment based on the PHQ-9. Please work with your health care provider for proper assessment, evaluation and treatment of depression. A questionnaire is not a substitute for medical care. Depression is treatable and there is hope. Please share with us if you've found regular depression treatment monitoring like I've mentioned has been helpful.
7 comments posted
November 25, 2009 11:00 a.m.
Thanks for your interest- the PHQ-9 is available on line, but should ONLY be interpreted by a licensed heatlh care professional. It is a tool only and does NOT by itself confirm or make a diagnosis. It is a screen only and is avialble on our web site.
- MayoClinic.com staff
November 24, 2009 2:26 p.m.
Where can I get a copy of the PHQ-9?
- barb
February 24, 2009 11:08 p.m.
Dear Susan, I understand your fustration except mine was from the 20 year olds perspective. I was always tired. Couldn't get out of med. I would cry at dumb things, moody, and occasionally had thoughts that everyone's lives would be easier without me. So I started on Lexapro or Wellbutrin or Zoloft. These didn't work so I just thought there was something else wrong... I was wrong. I had depression I just needed to find a medication that is right for me. I have been on Cymbalta for a year and a half now and love it. I have had to make dose adjustments but I feel so much better. I hope you and your son can conitnue to work on this disorder and manage it like I have.
- Amanda
February 14, 2009 10:00 a.m.
My son has depression,I should have noticed the signs since his dad has it to, the doctor said to me when why did you let your husband get to bad before bring him to the doctor apparently my husband was the worst he had seen, my answer was I told him to stop and he would not listen to me, the doctor explained to me he would stop if he could. Any way after that you think I would have seen the signs when my now 20 year old son started looking back I think he was a depressed baby hardly ever laughed and would sit on my lap for hours. Well at age 16 we could not get him to get up he would sleep all day and at first stay up all night now he can sleep for 5 days in a row, we check to see if he is alive. The doctors said he was not depressed at first 3 doc I kept thinking ok I will find a doc that says what I think is wrong, at age 16 they don't let mom come back so he was lieing to the doc and when I went back I think they thougth I needed medicine. Now at age 20 he admitted he might have some anxiety which he does not like. He does not want to take med but the doc a 6th doc by this time to take Lexapro it is not working so he says, I saw a few smiles and was happy to see that. He still sleeps for days on end and won't work or go to school. He is very smart and naturally at age 20 knows more then the doc. I am not sure we will be able to get him to try another medicine or if maybe 4 weeks is not enough time on the medicine. It is very frustrating since he cares about nothing. time
- Susan
February 4, 2009 3:42 p.m.
I agree. I have both depression, and manic and anxiety episodes. My mind gets really fuzzy at times. Others don't understand and don't want to hear about it, tell me I am not right with God, if I had enough faith........ I'm going through a hard time again, wanting to cry, over-spend etc. I'm fortunate in the having support from a good psychologist, PNP, and church. But I am afraid that even with new med, I'll end up back in the hospital, where I don't want to be. (I have better things to do.) When my brain feels scrambled, it seems like nothing goes right.
- Eileen Larson
February 4, 2009 8:01 a.m.
Dear Karla, I know just how you are coping. A few years ago I developed neuropathy. My world turned upside down and depression set in as I never dreamed it could. And, you are on track belonging to the Mayo Clinic site. The thing that most people without depression understand is just as you say. They don't understand how our mind works to protect us. If one isn't depressed their world is entirely different. Everyday problems are simple and easily dealt with. For the depressed mind, simple circumstances sometimes can appear as large as mountains. Undoubtedly you have survived with clear a thinking mind with full awareness of your situation. Keep up the good work.
- Guy Valentine
February 3, 2009 4:38 p.m.
I've suffered with depression off and on for 30 years. I raised two children and have worked foe 28 years. I have major depression. It never completely goes away and the meds stop working after several years. I wish people would realize that it is a true chronic illness and not lazziness or a choice. Hopinf for a Vagal Nerve Stimulator which my insurance provider has refused up untill this point, My biggest fear: my children or grandscildren will suffer from this disease that I passed down. I always read articles that say how tratable it is but that is not the reality I have seen, in myself and others.
- Karla Knapke
7 comments posted