Liam Farrell: Depressed? How do you think I feel?

'I'm feeling a bit depressed,' he said. 'Once upon a time, kids would be grateful; now all I hear on Christmas morning is: "Is this all I get?".'

For reasons of confidentiality (discretion is my watchword) I can't reveal my patient's name, but let's just say a strong smell of reindeer manure pervaded the room.

'How depressed are you?' I said; I hadn't time for the usual niceties, it being the festive season and all, thousands clamouring at the door demanding their Christmas antibiotic, just in case, you know.

'Oh, not too bad, I suppose,' he said, gamely. 'But I thought, you know, maybe a few tablets?'

I quickly produced the dreaded PHQ-9, but judging by the way he began yanking out his beard in handfuls, this only depressed him further.

'Do you fidget (a) a lot, (b) a normal amount, or (c) only a little bit?' I asked, fidgeting a bit myself.

'Alas,' I said, totting up his score, 'you have mild to moderate depression and the latest guidelines are unequivocal; no medication for you. Take plenty of exercise, eat a balanced diet and try to get out a bit more.'

'What else do they suggest?' he asked, visibly unimpressed. 'There's counselling,' I said.

'That sounds good,' he said. 'Where do I go?'

'Hey, we can put the show on right here in the barn,' I said, hoping a festive Mickey Rooney reference might cheer him up. He seemed to find this unhelpful.

'Ho, ho, ho,' he said, half-heartedly. 'Anything else?' 'Of course,' I said, 'cognitive therapy is very effective.' 'Great,' he said, 'I'll try that.'

'Unfortunately,' I sympathised, 'because you're not an urgent case, I can't refer you directly. You'll have to see a psychiatrist first and non-urgent psychiatric cases are usually not seen for about six months, and the waiting list for cognitive therapy is another six months after that.'

'So it'll be next Christmas before they see me. What you're saying is, in effect, there are no treatments for mild to moderate depression.'

'Funny that, isn't it?' I said. 'Ho, ho, ho.'

  • Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell

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