Table 2.

Participant Statements about Missed Diagnoses of Depression

Patient unwilling or unable to raise the question of depression:
  • I never knew how to express it, and I had a shame in expressing it. I felt the shame in mentioning it to my family, even though my family had a whole depression issue. So if I couldn’t talk to my family, then how could I have talked about it to a doctor?

  • I was good at hiding it, until I just fell apart one day.

Provider unsuspecting, disinterested, or dismissive:
  • I had no indication that they were thinking about that while they were trying out other things. I presented myself with physical symptoms, and that was it.

  • I think that because the subject was about my pain, other matters at hand, that they didn’t ask about my sleeping habits, my mood, appetite. My doctor couldn’t have known.

  • I guess maybe I wasn’t really sure what was going on. And so, I probably didn’t mention it as problems I was having, and I perceived (my primary care doctor) as someone more interested in physical issues.

  • I had one person tell me it was all in my head, that there was nothing anyone could help.

  • When I mentioned it to my primary care doctor, he said, “Well, you smile—you don’t seem to be depressed.” So I just stopped mentioning it; that was about 2 years ago.