A 42-year-old woman sees her physician because she has been depressed for the past three months. She also notes that she has gained 20 lb without trying to. She notes that she does not take pleasure in the activities that she once enjoyed and seems fatigued most of the time. These symptoms have caused the patient to withdraw from many of the social functions that she once enjoyed. The physician diagnoses the patient with hypothyroidism and starts her on thyroid supplementation. Six weeks later, the patient’s thyroid hormone levels have normalized, but she still reports feeling depressed. Which of the following is the most appropriate next step in the management of this patient?

a. Recommend that the patient begin psychotherapy

b. Increase the patient’s thyroid supplementation

c. Start the patient on an antidepressant medication

d. Tell the patient that she should wait another six weeks, during which time her mood will improve

e. Take a substance abuse history from the patient

the answer is below…

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