Can a neurologist treat depression?

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Can a neurologist treat depression? Strictly speaking, no. Which doctor is best for treating depression? If you suspect you may have depression, your first visit should be to your family or primary care physician for a thorough checkup. S/he will do a thorough checkup and refer to a psychiatrist if s/he suspects depression, for further evaluation and treatment. Failing that, you should directly visit a psychiatrist rather than a neurologist if you suspect you are suffering from depression (Schimelpfening, 2019). Here is why.

Neurologist vs. Psychiatrist for Treating Depression: Similarities

Neurology has a close relationship with psychiatry, as both disciplines focus on the functions and disorders of the brain. Because both disciplines deal with the brain, the reality is that there is a tremendous overlap between the fields of psychiatry and neurology, and knowledge of both is essential to ensuring that all factors are considered in a diagnosis (Dementia.org, 2015).

Any adequate assessment of “brain function” must take account of cognition and behavior. The notion that only a minority of neurological disorders has a significant psychological or psychiatric dimension is almost certainly wrong. Cognitive and behavioral involvement is the rule, not the exception, among patients with disorders of the central nervous system. The physical and psychological symptoms of disease can, therefore, be related in the following ways: (1) physical symptoms manifest by way of complex psychological processes; (2) psychological upset can manifest itself in physical symptoms; (3) physical diseases commonly cause a secondary psychological reaction; (4) some diseases affecting the brain can directly lead to psychological manifestations (Butler & Zeman, 2005).

While neurological disorders involve damage to the nervous system, sometimes that damage can alter the signaling between neurons. When it does, those changes can manifest themselves in problems with behavior, memory, and mood, the problems that psychiatrists treat. That’s not surprising because problematic communication between neurons in our brain underpins psychiatric disorders (Galinato, 2018).

Both psychiatrists and neurologists have four years of training as medical doctors plus training in their specialties, and often, they work together to determine appropriate medications and therapies (Galinato, 2018). And, in the US, both have to get certified by the American Board of Psychiatry and Neurology. The certification exam requires knowledge of both psychiatry and neurology (Dementia.org, 2015). So, where do the differences lie?

Neurologist vs. Psychiatrist for Treating Depression: Differences

The difference between psychiatrists and neurologists is best seen in the context of the symptoms they treat. Psychiatrists deal with symptoms originating in the brain that lead to abnormal voluntary functions, i.e., human behaviors, whereas neurologists deal with symptoms originating in the brain that produce abnormal involuntary functions. For instance, in the case of depression, the patient will present with voluntary symptoms (that is, the patient has physical control, technically speaking), like social isolation, increased or decreased weight and stopping activities they once found enjoyable. By contrast, a stroke patient will present with involuntary symptoms (the body is in “automatic” mode), such as blurred vision, paralysis, headache, inability to communicate verbally and involuntary movements (Dementia.org, 2015). So, which doctor is best for treating depression?

Should you see a neurologist or psychiatrist for treatment of depression?

One should note that the treatment of depression is not merely a matter of writing a prescription for Prozac (fluoxetine). The causes of depression are diverse. The medications used to treat it are just as diverse. So, matching a drug with an individual is not a clear-cut decision. A person’s specific symptoms, co-existing illnesses, tolerance of side-effects, and medications previously tried are just a few factors that are considered when your doctor chooses your antidepressant. Also, if you are noticing very little or no improvement in your symptoms after two to four weeks, your doctor may increase your dose, add another medication to increase its effect, or switch your medication. Hence, a psychiatrist, rather than a neurologist, is in the best position to do all these things given the number of cases of depression and other mental disorders cases he sees and treats on a daily basis (Schimelpfening, 2019).

Moreover, sometimes, a patient with depression may need psychotherapy, either as a standalone treatment or combined with medication. A neurologist is not trained to administer psychotherapy to a depressed patient. Hence, a psychiatrist is needed in such scenarios.

Thus, seen every which way, a psychiatrist is the right option rather than a neurologist for treatment of depression.

References

Butler, C. & Zeman, A., 2005. Neurological syndromes which can be mistaken for psychiatric conditions. [Online]
Available at: https://jnnp.bmj.com/content/76/suppl_1/i31
[Accessed 14 Sep 2019].

Dementia.org, 2015. Should I See A Psychiatrist, Or A Neurologist?. [Online]
Available at: https://www.dementia.org/diagnosing-dementia-psychiatrist-or-neurologist
[Accessed 14 Sep 2019].

Galinato, M., 2018. What Is the Difference Between Neurological and Psychiatric Disorders?. [Online]
Available at: https://www.brainfacts.org/diseases-and-disorders/mental-health/2018/what-is-the-difference-between-neurological-and-psychiatric-disorders-070618
[Accessed 14 Sep 2019].

Schimelpfening, N., 2019. What to Expect When Seeing a Doctor for Depression. [Online]
Available at: https://www.verywellmind.com/which-doctor-is-best-for-treating-depression-1065269
[Accessed 14 Sep 2019].

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Can a neurologist treat depression?
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Can a neurologist treat depression?
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"Can a neurologist treat depression?" is discussed in the context of similarities and differences between a neurologist and psychiatrist.
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