October 10, 2019

How In-Home Medical Care Impacts Depression

Learn about the signs of depression and how Landmark’s behavioral health team identifies and treats depression at various stages of the illness.

Depressive disorder, often referred to as depression, is an illness that affects over 16 million American adults each year, according to the National Alliance on Mental Illness (NAMI).1 Depression can present with varying symptoms depending on the individual. For most people, a depressive disorder changes how they function day-to-day, and typically for longer than two weeks. (Source: NAMI)

Many factors can contribute to depression, including family history, certain medicines, the use of drugs or alcohol, grief or extreme stress, and behavioral/mental health disorders. The best way to find out if you are depressed is to consider how you feel and discuss your concerns with your doctor.

Symptoms of depression can vary and may include:

  • Persistent feelings of sadness, hopelessness, worthlessness or inappropriate guilt
  • Restlessness, irritability, excessive crying, anxiety
  • Sleeping too much or too little
  • Loss of interest or pleasure in activities once enjoyed
  • Weight gain or weight loss
  • Fatigue or a lack of energy
  • Difficulty concentrating
  • Thoughts of self-harm

Often, a patient’s depression goes untreated due to the stigma associated with seeking help, the lack of available treatment options, or access to affordable care.

The stigma of mental illness

The stigma associated with mental illness, including depression, creates barriers to getting treatment. Behavioral health treatments are sometimes considered outside the realm of “traditional” medical practices. This perception can further alienate those with depression, anxiety, or other mental health concerns. When behavioral health services are kept separate from primary care, patients who are already overwhelmed may be less likely to seek those additional services.

How In Home Medical Care Impacts Depression

Managing chronic conditions and depression

Patients managing multiple chronic health conditions are at a higher risk of having depression. Mental health is as important as physical health, and that is why all Landmark Health patients have access to behavioral health provider visits by psychiatrists, psychiatric nurse practitioners and/or physician assistants). Landmark’s behavioral health team identifies and treats depression at various stages of the illness.

Landmark behavioral health specialists assess patient needs and can:

  • Prescribe or adjust medication
  • Provide brief therapeutic intervention(s)
  • Support ongoing treatment needs and connects patients to outside resources

In addition, Landmark Health social workers also offer brief therapeutic interventions as well as guidance and information about community resources, which can support a Behavioral health treatment plan.

One of Landmark’s psychiatric nurse practitioners, Andrea Lukowski, PMHNP,  says, “As a Landmark behavioral health provider, I help patients by treating mental health issues with an integrative health and medicine approach. We have the advantage of screening, assessing and treating each patient in the comfort of the patient’s home. We can provide patients with preventative health education and recommend treatments.”

The “whole-patient” approach to treating depression

According to Lukowski, Landmark considers more than just mental health when treating the patient for depression. She says, “When treating a patient for depression, I consider the patient as a whole. I treat them with an individualized plan of care. Many therapies to treat depression don’t require a medicinal approach. Mindfulness, meditation, gentle exercise such as yoga/stretching, psychotherapy, and a nutrient-rich diet can make a big difference in the patient’s mental health.”

Lukowski continues, “Some patients have been prescribed medicines from different providers. These patients can feel overwhelmed by different diagnoses and treatments, making depression worse. Landmark’s team reviews current medications for effectiveness and possible interactions. I fact, many patients’ health goals include taking fewer medications.”

Lukowski sometimes recommends starting an antidepressant or adjusting the dose if the patient is already taking an antidepressant. She says, “I check in with the patient regularly to see if they need a dosage adjustment and to watch for potential side effects.”

Family and caregivers can be an important part of improving mental health as well. Lukowski says, “We treat our patients as a whole, and their family and caregivers are often a big part of their lives. If their caregivers are unhappy or feeling stress or even “burned out,” the patient will feel the effects of that. Our behavioral health providers and social work team can also help caregivers find respite care and support groups in the area.”

Recovery is on the other side.

Depression can have negative effects on one’s life and their loved ones. It might feel overwhelming to think about where to even begin and what steps to take. However, you are not alone, and depression can be treated and managed! The first step is to contact a provider of your choice if you think you might be experiencing depression. You can also call SAMHSA’s National Helpline-1-800-662-HELP (4357) to get more information on depression and treatment resources.

At Landmark Health we believe that everyone has the ability to reach their health goals and fulfill their wellbeing potential. Everyone deserves and has the right to feel their best.

If you are a Landmark patient, be sure to talk to your Landmark provider or care team if you are having any symptoms of depression. We have the specialists available to help, 24/7.



  1. https://www.nami.org/Learn-More/Mental-Health-Conditions/Depression