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How Do Doctors Diagnose Depression

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What Can I Do If I Have Depression

DEPRESSION | How do Doctors Diagnose & Treat Depression?

If you have symptoms of depression, see your healthcare provider. They can give you an accurate diagnosis, refer you to a specialist or suggest treatment options.

If you or someone you know is thinking of hurting themselves or taking their own life:

  • Go to the emergency department of your hospital.
  • Contact a healthcare provider.
  • Speak to a trusted friend, family member or spiritual leader.

A note from Cleveland Clinic

Depression is a common condition that affects millions of Americans every year. Anyone can experience depression even if there doesnt seem to be a reason for it. Causes of depression include difficulties in life, brain chemistry abnormalities, some medications and physical conditions. The good news is that depression is treatable. If you have symptoms of depression, talk to your healthcare provider. The sooner you get help, the sooner you can feel better

Last reviewed by a Cleveland Clinic medical professional on 12/31/2020.

References

You Have Little Or No Energy Most Of The Time

When youre struggling psychologically, your body feels it, too. Depression can drain your energy quickly, and you might find yourself feeling fatigued on most days. Moving slowly, forgoing exercise and longing just to lie down are all common with depression.

You might lack the energy to upkeep your household or care for children or pets, and even small tasks like showering can feel like insurmountable chores.

Depression Diagnosis And How Is Depression Diagnosed

Diagnosis of depression, and other mental illnesses, is different than for many other medical conditions. The depression diagnosis relies on information supplied by the patient both passively and through interviews. While this may seem haphazard, a depression diagnosis is highly standardized. Depression diagnostic criteria are clearly laid out, as is the examination used to evaluate those criteria.

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Enlist Trusted And Educated Allies

You are the expert on your own feelings. No one, not even your therapist, knows more about your experience with depression than you do. But if the job of explaining your symptoms and answering questions feels like a burden, you can ask for help. Health professionals are trained and experienced in educating family members.

The person with depression is not usually the best person to have to explain it, Dr. Rosmarin says. Its hard enough to explain depression when youre firing on all cylinders. If youre not, you might prefer to offer your relatives a chance to speak to someone on your clinical team.

In fact, there is good

How Do Doctors Diagnose Depression Here Are The Common Tests They Use:

Depression Diagnosis and Screening: What Doctors Look For

Currently the most common ones are:

  • Hamilton Depression Rating Scale
  • Montgomery-Asberg Depression Rating Scale
  • Beck Depression Inventory
  • Patient Health Questionnaire
  • Your doctor will likely used one of these tests to assess you. Questions are similar in nature for each. They ask you about symptoms your experiencing such as: Sleep disturbances, issues with fatigue, suicidal thoughts, feeling uninspired or hopeless, loss of motivation, loss of pleasure. They will also ask you questions to help them understand the severity of your symptoms.

    Here are some examples of the types of questions you may be asked:

    • Have you lost interest in activities you used to find pleasurable?
    • Ae you experiencing changes in appetite such as eating too much or not feeling like you want to eat?
    • Are you having difficulty concentrating?
    • Having you been experiencing thoughts of suicide, death, or wanting to die?

    In most cases, if you have felt hopeless for a least two weeks or more and its so bad its affecting your life youre having trouble going to work, socializing, enjoying activities you once thought were pleasurable etc. these are high indications you have depression.

    The diagnostic criteria for depression appears in a medical text for mental illness called the DSM-IV. .

    Your doctor will also likely run some basic biological tests to rule out other potential issues that cause depression. The most common ones are the:

    How doctors fix depression: Antidepressants

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    Testing For Other Medical Conditions

    Because the symptoms of postpartum depression are so broad, doctors will want to ensure that symptoms like depression, irritability, anxiety and fatigue are not the result of a thyroid dysfunction.

    After childbirth, many women develop an underactive thyroid condition called postpartum thyroiditis. This condition causes similar symptoms to postpartum depression and include anxiety, fatigue, irritability and inability to concentrate.

    Doctors may perform a blood test to determine if a thyroid condition is the underlying cause of the postpartum depression symptoms. Doctors may also look for other medical conditions such as a vitamin deficiency, malnutrition or other ailments that can cause depression, anxiety and fatigue.

    Once the doctors have ruled out other medical conditions, they are able to move toward reaching a postpartum depression diagnosis.

    What Are The Different Types Of Depression

    Two common forms of depression are:

    • Major depression, which includes symptoms of depression most of the time for at least 2 weeks that typically interfere with ones ability to work, sleep, study, and eat.
    • Persistent depressive disorder , which often includes less severe symptoms of depression that last much longer, typically for at least 2 years.

    Other forms of depression include:

    • Perinatal depression, which occurs when a woman experiences major depression during pregnancy or after delivery .
    • Seasonal affective disorder, which comes and goes with the seasons, typically starting in late fall and early winter and going away during spring and summer.
    • Depression with symptoms of psychosis, which is a severe form of depression where a person experiences psychosis symptoms, such as delusions or hallucinations .

    Individuals diagnosed with bipolar disorder also experience depression.

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    Diagnosing Depression And Other Testing Methods

    The doctor may include other standard tests as part of the initial physical exam. Among them may be blood tests to check electrolytes, liver function, toxicology screening, and kidney function. Because the kidneys and liver are responsible for the elimination of depression medications, impairment to either of these two organs may cause the drugs to accumulate in the body.

    Other tests may sometimes include:

    • CT scan or MRI of the brain to rule out serious illnesses such as a brain tumor
    • Electrocardiogram to diagnose some heart problems
    • Electroencephalogram to record electrical activity of the brain

    Preparing For A Health Appointment

    How do doctors test you for depression?

    Talking to health professionals may be intimidating, but you and your health professional do need to work together. Remember, your doctor can’t provide the best information if they don’t know what the problem is, and they can’t offer the best-suited treatment options if they dont know your goals or concerns. Here is a checklist to help keep you on track during your appointments.

    Before the appointment

    PlanThink of what you want to tell your doctor or what you want to learn from your health professional at this appointment. Decide what is the most important to you. If you have particular questions, write them down. You can bring your list to the appointment. If you take any medication, including over-the-counter medication, plan to bring it with you.

    During the appointment

    ReportTell your doctor what you want to talk about during this appointment

    Exchange informationMake sure you tell the doctor whats wrong. It may be helpful to bring in a self-test youve completed or a diary of symptoms. Remember to explain how your problem affects your day-to-day life. You can bring a loved one with you, and they can help describe changes theyve noticed.

    ParticipateTalk with your doctor about the different ways to handle your health problem. Make sure you understand the positive and negative features of your choices. Ask as many questions as you need.

    AgreeBe sure that you and your doctor agree on a treatment plan that you can live with.

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    How Is Depression Syndrome Treated

    Depression can be serious, but its also treatable. Treatment for depression includes:

    • Self-help: Regular exercise, getting enough sleep, and spending time with people you care about can improve depression symptoms.
    • Counseling: Counseling or psychotherapy is talking with a mental health professional. Your counselor helps you address your problems and develop coping skills. Sometimes brief therapy is all you need. Other people continue therapy longer.
    • Alternative medicine: People with mild depression or ongoing symptoms can improve their well-being with complementary therapy. Therapy may include massage, acupuncture, hypnosis and biofeedback.
    • Medication: Prescription medicine called antidepressants can help change brain chemistry that causes depression. Antidepressants can take a few weeks to have an effect. Some antidepressants have side effects, which often improve with time. If they dont, talk to your provider. A different medications may work better for you.
    • Brain stimulation therapy: Brain stimulation therapy can help people who have severe depression or depression with psychosis. Types of brain stimulation therapy include electroconvulsive therapy , transcranial magnetic stimulation and vagus nerve stimulation .

    Where Do I Go From Here

    Your doctor or mental health professional can recommend resources in your community. In addition to professional resources, you may find non-professional support helpful.

    BC Partners for Mental Health and Substance Use Information

    Visit www.heretohelp.bc.ca for more info sheets on depression and mood disorders, self-tests and personal stories. Visions Journal, our magazine, brings together mental health professionals, people managing mental illnesses, family members, and communities. You can also find the info sheets When You’re Diagnosed with Depression and Preventing Relapse from Depression.

    Support groups

    Support groups are an important way to find support and information. They may help you feel less alone and more connected, even if you haven’t told many others about your diagnosis. You can find support groups in your community through the Mood Disorders Association of BC online at www.mdabc.net or by phone at 604-873-0103. You can also find support groups online. For more on choosing the right support group for you, see the info sheet Choosing a Support Group that’s Right for You.

    Understanding Psychiatric Medications

    The Centre for Addiction and Mental Health in Ontario offers guides for four different kinds of psychiatric medications: antidepressants, antipsychotics, mood stabilizers and benzodiazepines. You can find these guides online at www.camh.net.

    Canadian Network for Mood and Anxiety Treatments
    Learn more
    About the author

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    What A Therapist Looks For

    An evaluation with a mental health professional can give you more answers about your mental health, including a formal diagnosis.

    To understand your symptoms and see whether theyre indicative of depression, a therapist will want to know how long your symptoms have lasted and how severely they impact your daily life. A major depressive episode must have lasted for at least two weeks for a therapist to make a diagnosis of a mental health condition.

    To make an accurate and informed diagnosis, your therapist will also want to rule out other causes of your symptoms. They will likely ask you about:

    • Grief from a recent loss
    • Past or recent trauma, including physical or psychological abuse or injury
    • Recent life changes, like pregnancy or divorce
    • Substance abuse problems
    • Your mental health history

    What If My Symptoms Dont Improve

    ADHD Diagnosis and Testing Guide: ADD Symptom Evaluations

    If youre not responding to treatment, you may live with treatment resistant depression. This is when your symptoms have not improved after at least 2 standard treatments. This can also be known as treatment-refractory depression.

    There is currently no official criteria used to diagnose treatment resistant depression.

    What treatment is available for treatment-resistant depression?There are treatment options for treatment resistant depression. Even if antidepressants have not worked already for you, your doctor may suggest a different antidepressant from a different class.

    The new antidepressant you are offered will depend on the first antidepressant you were given.

    Sometimes your doctor can prescribe a second type of medication to go with your antidepressant. This can sometimes help the antidepressant work better than it does by itself.

    Where antidepressants have not worked, your doctor may suggest talking therapies, ECT or brain stimulation treatments. See the previous section for more information on these.

    What is an implanted vagus nerve stimulator, and how is it used in treatment resistant depression?If you live with treatment resistant depression, and youve not responded to other treatments, you may be able ask for an implanted vagus nerve stimulator.

    Please speak to your doctor if youre interested in this treatment and for more information. You may be able to get this treatment funded through an Individual Funding Request.

    • NHS – Your Rights by clicking here.

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    Patients With Chronic Medical Conditions

    The incidence of depression is higher in patients with chronic medical conditions. A Canadian study demonstrated a 1.45 times greater risk of depression in these patients.44 A study of the relationship between depression and diabetes and coronary artery disease specifically showed it to be bidirectional.45 Given these findings, physicians should consider screening patients with chronic medical conditions for depression. Physicians should also be mindful that many symptoms commonly attributed to chronic medical conditions are also symptoms of underlying depression.

    What Is Samhsa’s National Helpline

    SAMHSAs National Helpline, , or TTY: is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.

    Also visit the online treatment locator.

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    How Do You Diagnose Depression

    As a rule, psychiatrists diagnose depression during a conversation with patients. Usually, they offer people to fill out several questionnaires. With the help of these questionnaires, the specialist will find out if the person has lost interest in life, if he is good at personal hygiene, and so on. In general, the questionnaires help to quickly identify symptoms of mental disorder. A diagnosis of depression is made only if the patient is found to have a large number of symptoms. In this case, during the conversation, psychiatrists try to find out how long the symptoms take place. If a person is sad for a couple of days, there is nothing wrong with it, and if it lasts more than two weeks the persons problems are clearly worth paying attention.

    How Common Is This In My Practice

    How Do Doctors Diagnose Anxiety?

    The Singapore Mental Health Study 2010 reported that major depression was the most common mental illness with a lifetime prevalence of 5.8%, followed by alcohol abuse and obsessive compulsive disorder. However, only 18% of patients with mental disorders sought help from primary care practitioners. The risk of major depression is significantly higher in the older population. As such, primary care doctors need to be familiar with the diagnosis and management of major depression.

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    What To Do If Youre Diagnosed With Anxiety

    Focus on managing your anxiety rather than on ending or curing it. Learning how best to control your anxiety can help you live a more fulfilled life. You can work on stopping your anxiety symptoms from getting in the way of reaching your goals or aspirations.

    To help manage your anxiety, you have several options.

    Can A Blood Test Diagnose Your Depression

    Researchers are closing in on a host of helpful blood tests. Heres the latest developments.

    When youre running a fever and feeling bad, your doctor will request lab tests to help determine whats making you ill. A simple blood test can pinpoint the diagnosis and help your doctor prescribe the best treatment. But symptoms of mental illness are far more complex to diagnose and treat so researchers are working to develop clinical tests diagnose depression and determine the best treatment.

    If you struggle with depression or know someone who does, this news is huge. Seeking treatment and help is the first step towards recovery one that those suffering with depression symptoms often find difficult because their condition has left them tired, disinterested or feeling defeated. Knowing that a doctor or clinic can run blood tests to help kick-start recovery is a game changer.

    But is it here now? Researchers have found some promising results:

    Doctors routinely use blood tests to rule out medical conditions that may cause symptoms of depression or even contribute to depression, such as anemia, thyroid disease or a vitamin D deficiency. They also use series of questions or a questionnaire to screen for depression, along with a detailed medical history and a discussion of your mood and how it impacts your daily life.

    Wondering if you are at risk for depression? Take Dominion Hospitals confidential and free online Depression Risk Assessment.

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    See A Mental Health Professional

    If your doctor diagnoses you with depression, you may then be referred to a mental health professional, such as a psychiatrist. The psychiatrist will further evaluate your mood and determine whether or not medication is needed.

    Some people will do fine being treated by their primary care physician. Others may benefit from seeing a psychiatrist, especially if symptoms are not improving with the first trial of an antidepressant or the depression is severe from the start.

    Research suggests that the combination of medication and therapy is most effective for treating depression. If you would benefit from psychotherapy, your psychiatrist may handle this as well, although some elect to refer patients to another mental health professional, like a psychologist.

    Questions Doctors Ask When Screening For Depression

    How do doctors diagnose teen depression?

    Mental health professionals rely on a number of screening tools to accurately diagnose depression. Here’s a peek at the questions they ask so you can assess your own risk.

    Not everyone experiences the same warning signs of depression. Some people may endure sadness, hopelessness, feelings of guilt others may lose interest in their favorite activities, have trouble thinking clearly, or face fatigue and changes in their sleeping or eating patterns. Thats why diagnosing depression isnt always easy and why doctors have developed a number of screening tools to help determine if you are at risk.

    “Diagnosing depression requires a complete history and physical exam, says Richard Shadick, PhD, associate adjunct professor of psychology and director of the counseling center at Pace University in New York City. Doctors must also rule out medical problems such as thyroid disease and consider coexisting emotional health issues like anxiety disorder, post traumatic stress, and substance abuse.

    What goes into a depression screening? “There are many types of depression scales and depression screens, explains Shadick. The questions asked look for common symptoms as well as how much these symptoms might be affecting a person’s ability to function and maintain relationships.”

    Which Depression Screening Will Your Doctor Use?

    The Type of Questions Your Doctor Will Ask

    Here are some typical questions from a few of the more common depression screening scales:

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