Psyched out! By Chris Woodall Family doctors are on the front lines of stress diagnosis, giving them a valuable role to play in detecting early signs of a patient's mental illness. A recent series of annual seminars held at the Delta Whistler Resort helped family doctors from Whistler and across Canada learn how to identify mental illness in their patients and pick up some suggestions about treating them. And Prozac watch out: there is a new wave of anti-depressants coming onto the market that will help continue the revolution in depression treatment. Since the 1980s when awareness of depression and stress became part of everyday news reports, physicians have had to get a better handle on the mental illnesses of their patients and especially how mental and physical illness can be linked, say doctors Alan Buchanan and Tony Sehon. They are the course organizers and directors of Psychiatric Update for Family Physicians — a multi-day seminar series held at major locations across Canada, including Whistler. The two clinical associate professors at the University of British Columbia saw a need for the seminars in the late 1980s when concerns about depression became the topic of the day. "We had been working on mood disorders at UBC and produced a video on depression that ran on public television," says Dr. Sehon. Out of that came recognition of a need to provide a conference on patients with depression for family doctors. "Doctors have to treat a wide range of psychiatric patients because the patients either can't afford to see a psychiatrist or the waiting lists are too long," Dr. Sehon says. The first conference addressed what doctors were seeing coming into their office. It has since grown to tackle a number of mental health issues, from identifying a variety of mental disorders to therapy and treatment techniques. Not only has the family doctor had to add knowledge of depression and other mental disorders to his or her over-all medical ability, but Drs. Sehon and Buchanan say it's a constant upgrading process. Because of stories on stress, depression and ways to cure them — from taking pills to spiritual awareness avenues — some doctors are finding their patients know more about the subject than the general practitioner. Knowing which drugs are on the market and how to use them in treatment is an important issue for the family doctor, Drs. Buchanan and Sehon say. "Prozac was a big change for family doctors. It is better than the old drugs because of problems with side effects and potential overdoses," the doctors say. Buchanan and Sehon are excited about new anti-depressant drugs that will be on the market soon. "There's not a dud in the bunch," they say of these drugs' few side effects and ability to cure the patient quickly. But drugs aren't the be-all and end-all of treatment. "The ideal combination is talk and medicine," the doctors say. Family doctors under 40 especially — because of medical schools' evolved training — are in tune to a variety of therapies that involve the patient taking charge of his or her situation through better verbal techniques. In cognitive therapy, for example, the doctor helps the patient examine how the patient thinks about his or her situation, rather than reacting to how he or she feels. "Ultimately the patient does their own therapy. It gives them a sense of mastery by looking at their life in a more positive, balanced fashion," Drs. Buchanan and Sehon say.