If you believe a patient is depressed, the first step is to talk to him about his feelings. This isn't always easy, especially if he isn't used to expressing emotions. Ask him if he's feeling sad or hopeless. Try to get an idea if it's really depression or just a temporary case of the blues.
The next step is to schedule an evaluation. His primary care physician may want to talk to him first, or she may refer him to a psychiatrist or counselor. In any case, the evaluating doctor will talk to him and assess his mood. She may also order screening tests to rule out other medical conditions that can mimic depression, such as a thyroid disorder or infection.
If he resists the idea of testing because he's embarrassed or afraid, help him understand that a diagnosis of depression isn't the shameful secret it once may have been. It doesn't mean he's "crazy" or is going to be taken away to a nursing home. And his test results are private, so no one but he and his doctor needs to know.
If he absolutely refuses to see a doctor, there's not a whole lot you can do. "There's no way to force the issue unless there are severe circumstances," says Castle. If he has become psychotic or suicidal, or if his depression has progressed to the point where he can no longer care for himself, Castle recommends that you notify his doctor or emergency medical services immediately. Otherwise, your best bet is to enlist family members and friends to try to persuade him to seek help.
