Vivian: Based on what you've told me and your responses to the questionnaire, it sounds like you're feeling down some of the time. You have a high, but normal, BDI score, and this is a possible risk for developing depression during interferon treatment. You might benefit from an antidepressant. Sometimes we give antidepressants before starting interferon treatment to help prevent depression, although we could also monitor depression symptoms. Since you got depressed last time you took interferon, I think an antidepressant might help.

William: No. I don't want to get hooked. Are you talking about some kind of "upper"? You don't think I'm crazy do you?

Vivian: No. Actually depression is a very common condition that can affect anyone. Fortunately, treatment is effective for the large majority of people and is not habit forming. The newer medicines are easy to take for most people.

William: But I heard that some of those drugs can have bad effects on the intimate parts of my marital relationship.

Vivian: Yes, some do, but there are a variety of medications we can try. We can use one with a low risk of sexual side effects.

William: No. I just don't feel comfortable taking that stuff. Besides, I feel okay right now.