Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression


anti-depressant “Anti-depressant Medication Authorization”: “We cannot be certain that the cause of a patient’s alleged depression falls upon us. The patient could be depressed for a number of reasons, and we are not going to get caught up approving anti-depressants for these folks.”

This is a very common source of resistance when patients were depressed before, during the course of, or following the occurrence of work injury. And here’s the problem:

Depression, regardless of its source, will slow down recovery. The depressed patient will not fully participate in therapies designed to rehabilitate him/her. S/he may be now chronically fatigued, melancholic, agitated, futile-feeling and have decidedly poor response to attempts to decrease their pain.

Simple reality: Antidepressants can help. And we are not referring to complex, multi-drug, expensive regimens. We are talking about drugs known to promote good sleep, stabilize appetite, reduce pain and restore energy. Anti-depressants can also assist with the patient’s problems with memory and decision.

But this is more important: A patient who is depressed during the course of recovery from injury feels abandoned when prescribed medication for which there is no authorization or authorization is withdrawn.

Very often insurers behave as though “if I do not approve this medication, the patient will improve without it and we maintain control”. This is, of course, a reflexive action that has no basis in science; it is merely an expression of the need for control of the situation and the patient.

Authorization for a simple and inexpensive anti-depressant regimen is often blocked while authorization for injections, even if unsuccessful, continues even though the goal for the medication is to hasten the patient’s compliance and mobilization.

Anti-depressants are not, thereby, a burden; they are a tool that can enable the patient to deal with the injury and ward off symptoms that otherwise impede the entire recovery process.”

Three Best in Atlanta

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