I am taking medication for both depression and a thyroid problem. Lately I have had a lot of trouble with my depression, but I don't know whether I should talk to my primary care doctor or my psychiatrist. Any suggestions?

--Sharon

The short answer is both. Your primary care doctor, who's prescribing your thyroid medication, and your psychiatrist, who's presumably prescribing your antidepressant, both need to know about changes in your symptoms -- in this case, your increased feelings of depression.

You don't say the nature of your thyroid problem and whether it's connected to your depression. That might be important information in deciding on treatment. For instance, depression is a common consequence of hypothyroidism, in which a person's thyroid is underfunctioning. In such cases, appropriately treating the thyroid condition can alleviate the depression.

The interrelation between these conditions is another reason why both of your doctors need to be on the same page about your care. If necessary (and with your permission), your doctors can consult with each other about your condition and any medication changes or adjustments.

Another option to consider is psychotherapy, particularly if your depression is related to your health problems. Psychological treatment is effective in treating depression and can often help people alleviate the stresses and problems associated with chronic medical conditions.