“It doesn’t matter what the causes are,” Occhipinti says. “If you’re feeling depressed and it’s interfering with your normal functioning, then telling someone is the first step.”  That could mean a pastor, a school counselor, a therapist or a primary care physician.

Tyler Friedrich, MD, a hospitalist in Denver, encourages patients to speak up. “Appointments are pretty quick, and we can’t always cover everything in one visit,” he says. “But if I have even the slightest indication that there’s a mental health issue, there’s a two-question screening tool.”  That test, called a Patient Health Questionnaire 2 (PHQ-2), assesses your feelings over the past two weeks. “If you flag positive, we move to a more diagnostic test, the PHQ-9,” he says, adding that the PHQ-2 is given automatically to veterans every six months. Although primary care doctors do have some tools to help with depression, such as the ability to prescribe medications and discuss possible lifestyle changes, most will refer you to a therapist.

If you see a therapist, she or he will first conduct a thorough assessment by delving into your medical history, family medical history, possible childhood trauma and daily lifestyle—including diet, exercise, prescriptions, job stress and relationship issues. Then you and the therapist will discuss what to do, which may include new or changed habits and a specific therapy (there are hundreds, including cognitive behavioral therapy and emotion-focused therapy). “The best therapist will assess how you function and what works for you in your life,” Clark says.

Confidence in your therapist is essential, so if you aren’t comfortable with the one you choose, keep trying, says Clark. Many organizations (see Online Resources) offer advice on choosing a therapist. The Anxiety and Depression Association of America (adaa.org) offers a list of questions you should ask potential counselors, including practical ones (“Do you accept my insurance?”) and more clinical ones (“What is your treatment approach?”).