Mild depression — RACGP Fellowship MCQ

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EasyMental healthMild depressionRACGP Fellowship

A 23-year-old woman presents with low mood following a relationship breakdown. She describes mild symptoms, maintains her work performance, denies suicidal ideation and has strong family support. What is the most appropriate initial management?

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Correct answer: A — Provide psychoeducation, active monitoring and psychological strategies

For mild depression, especially in patients with preserved function, no suicidality, and adequate support, initial management should be non-pharmacological—comprising psychoeducation, monitoring and psychological strategies like problem-solving or structured counselling. The RACGP explicitly advises against routine antidepressant use in mild depression; these are reserved for moderate–severe cases or where psychosocial interventions are unavailable or have failed. Option E is incorrect as antidepressants are not first-line for mild depression. Option C is incorrect since the patient is not at risk of harm. Option D is inappropriate because long-term benzodiazepine use is not recommended and does not treat underlying depression. Option B is unnecessary: neuroimaging is not indicated in uncomplicated presentations. Thus, A is the single best answer.

Reference: Royal Australian College of General Practitioners. Depression and anxiety – A General Practice Management Toolkit. https://www.racgp.org.au/getattachment/87865c41-fdd7-4eb1-8920-cb0c7f02d8a9/attachment.aspx