In earlier chapters I have provided some guidelines as to how to diagnose your own depression and when it might make sense to involve a doctor in its treatment. In this chapter I go into greater detail about this. Essentially there are five reasons for involving a doctor in the treatment of depression. First, if depression is severe, it is risky to treat it on one’s own. In addition, there is far less evidence for the efficacy of St John’s Wort in severe depression than there is for more conventional anti-depressants. Second, other conditions may masquerade as depression. A visit to a doctor may uncover the real reason for symptoms and lead to a specific and effective treatment for them. Treating such conditions with conventional anti-depressant strategies may be ineffective and will delay treatment of the underlying problem. Third, there may be other psychiatric problems that are worthy of attention in their own right and depression may even be secondary to these other problems. Treating these other conditions may be the first order of business and requires the help of a doctor. Fourth, it can be difficult to be the best judge of your own mood and progress, and a skilful observer and experienced clinician is an invaluable companion in the treatment of depression. Finally, depression is a lonely condition and a good doctor is also like a good friend to cheer you on through the dark wood into a better and brighter place.

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