Dating a person with severe depression
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off‑label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.Make all efforts necessary to ensure that a person with depression can give meaningful and informed consent before treatment starts.This is especially important when a person has severe depression or is subject to the Mental Health Act.For people with recurrent severe depression or depression with psychotic symptoms and for those who have been treated under the Mental Health Act, consider developing advance decisions and advance statements collaboratively with the person.Box 1 Depression definitions (taken from DSM-IV) Subthreshold depressive symptoms: Fewer than 5 symptoms of depression.Mild depression: Few, if any, symptoms in excess of the 5 required to make the diagnosis, and symptoms result in only minor functional impairment.Record the decisions and statements and include copies in the person's care plan in primary and secondary care.
Only for depression where the person also has a chronic physical health problem and associated functional impairment (see depression in adults with a chronic physical health problem: recognition and management [NICE clinical guideline 91]).
This is particularly important during high-risk periods, such as starting or changing treatment and at times of increased personal stress.
When depression is accompanied by symptoms of anxiety, the first priority should usually be to treat the depression.
The main issue concerns the impact of other physical disorders on the treatment of depression.
Refer to 'Depression in adults with a chronic physical health problem: recognition and management' (NICE clinical guideline 91) for further information.
Be respectful of, and sensitive to, diverse cultural, ethnic and religious backgrounds when working with people with depression, and be aware of the possible variations in the presentation of depression.