Depression and anxiety are among the most treatable conditions in medicine, and your primary care provider is a legitimate place to start — most people never need to find a specialist on their own. A first appointment is a conversation, two short questionnaires, usually some blood work to rule out physical causes, and a plan. That is it.
If you are in crisis right now, the 988 Suicide and Crisis Lifeline is free, confidential, and staffed 24 hours a day: call or text 988.
When it is worth making an appointment
Not every difficult stretch needs treatment. The threshold most clinicians use is duration and function: symptoms lasting more than about two weeks, and getting in the way of work, relationships, or daily life.
Worth a visit if you have had:
- Persistent low mood, or loss of interest in things you used to enjoy
- Anxiety or worry you cannot switch off
- Sleep that has changed markedly — too little or too much
- Appetite or weight change
- Exhaustion that rest does not fix
- Difficulty concentrating or making decisions
- Irritability or anger that feels out of proportion
- Feeling worthless, or excessively guilty
- Physical symptoms with no explanation — headaches, stomach problems, chest tightness, muscle pain
- Drinking or using substances more to cope
- Panic attacks
- Any thoughts of harming yourself
That last one is not a reason to wait for a routine appointment. Call 988, or come to our Emergency Room, or call 911.
Note how many of those are physical. Depression and anxiety cause genuine bodily symptoms, and a great many people arrive with fatigue, pain, or palpitations and no idea the two are connected.
What a first appointment involves
There is far less to it than people fear.
We talk — about what has changed, how long, and what it is affecting. You will likely complete a PHQ-9 (depression) and GAD-7 (anxiety), which each take about two minutes and give a measurable baseline so we can tell whether treatment is working.
We usually do blood work, because several physical conditions mimic depression: an underactive thyroid, anaemia, vitamin B12 or vitamin D deficiency, and poorly controlled diabetes among them. Our laboratory is in the building, so results typically come back the same day. We also review your medications, since some cause low mood as a side effect, and ask about alcohol and sleep.
Then we agree on a plan, which may be therapy, medication, both, or lifestyle-focused with a follow-up to check.
What treatment involves
Therapy. Cognitive behavioural therapy has strong evidence for both depression and anxiety, and works as well as medication for mild to moderate depression. Other approaches suit different people. It is a skill-building process, not open-ended talking. We can refer you, including to telehealth therapy, which has removed most of the access problem.
Medication. Antidepressants take four to six weeks to work properly — the most common reason people conclude they have failed is stopping at week two. Side effects are usually mild and often settle within a fortnight. They are not addictive in the way people fear, though stopping should be tapered rather than abrupt. If the first one does not suit you, another usually does; this is normal and not a failure.
Both together outperforms either alone for moderate to severe depression.
Lifestyle, as an adjunct rather than a substitute. Exercise has genuine antidepressant effect — the evidence is real. So do sleep regularity, reducing alcohol, sunlight, and social contact. These help meaningfully and they are not a replacement for treatment when someone is seriously unwell. Telling a person with major depression to go for a walk is not a plan.
About the stigma
Roughly one in five American adults experiences mental illness in a given year. It is as common as high blood pressure and no more a character flaw.
A few specifics worth naming. Men are far less likely to seek help and die by suicide at about four times the rate of women; depression in men often looks like irritability, anger, exhaustion, recklessness, or drinking rather than sadness. Older adults are frequently under-treated because low mood gets attributed to ageing, which it is not. And asking someone directly whether they are thinking of suicide does not plant the idea — that is a persistent myth, and asking plainly is one of the most protective things you can do.
You do not need to have a diagnosable disorder to deserve support, and you do not need to be in crisis to be allowed to ask.
Seasonal patterns in Arizona
Two local specifics that get missed.
Our seasonal affective pattern runs backwards. In northern states people struggle in dark winters. Here, the difficult months are June through September, when heat makes going outside genuinely unpleasant, activity collapses, and people become effectively housebound in air conditioning. If you feel flat every summer, that is a real pattern worth planning for — early-morning outdoor time, indoor exercise, and deliberate social contact.
Seasonal residents and isolation. Arriving for half the year, away from family and long-standing friendships and without a local provider, is a genuine risk factor for depression — and one that is easy to mistake for simply being tired from the move. If that is you, establishing care here matters for more than your blood pressure.
January is hard for plenty of people too: post-holiday letdown, financial strain, and resolutions that collapse by week three.
Crisis resources
- 988 Suicide and Crisis Lifeline — call or text 988, 24 hours, free and confidential
- Crisis Text Line — text HOME to 741741
- Veterans Crisis Line — call 988 then press 1
- Our Emergency Room — open 24 hours, 9700 N. Saguaro Blvd, for anyone at immediate risk
If someone is in danger right now, call 911, stay with them, and remove access to firearms and stockpiled medication if you safely can. Reducing access to lethal means is one of the most effective suicide-prevention measures there is.
Where to go
Book our Medical Clinic to start. You do not need to know what is wrong or have the words ready — “I have not felt right for a few months” is a complete reason to book. Call (602) 671-7981.
Related: men’s health · holiday health
Sources
- National Institute of Mental Health — Depression
- NIMH — Anxiety disorders
- 988 Suicide & Crisis Lifeline — 988lifeline.org
- US Preventive Services Task Force — Depression screening in adults