Depression (cont.)
How is depression diagnosed?
People who wonder if they should talk to their health professional about whether or not they have depression may consider taking a depression self-test, which asks
questions about depressive symptoms. The first step to obtaining appropriate treatment is accurate diagnosis, which requires a complete physical and psychological evaluation to determine whether the person may have a depressive illness, and if so, what type. Certain medications, as well as some medical conditions, can cause symptoms of depression. Therefore, the examining physician should rule out (exclude) these possibilities through an interview, physical examination, and laboratory tests. Many primary-care doctors use screening tools for depression, which are usually questionnaires that help identify people who have symptoms of depression and may need to receive a full mental-health evaluation.
A thorough diagnostic evaluation includes a complete history of the patient's
symptoms:
1. When did the symptoms start?
2. How long have they lasted?
3. How severe are they?
4. Have the symptoms occurred before, and if so, were
they treated and what treatment was received?
The doctor should ask about
alcohol and drug use and whether the patient has had thoughts about death or
suicide. Further, the history should include questions about whether other
family members have had a depressive illness, and if treated, what treatments
they received and which were effective.
A diagnostic evaluation also includes a mental-status examination to
determine if the patient's speech, thought pattern, or memory has been
affected, as often happens in the case of a depressive or manic-depressive
illness. As of today, there is no laboratory test, blood test, or X-ray that can
diagnose a mental disorder. Even the powerful CT, MRI, SPECT, and PET scans,
which can help diagnose other neurological disorders, such as stroke or brain
tumors, cannot detect the subtle and complex brain changes in psychiatric
illness. However, these techniques are currently useful in research on mental
health and perhaps in the future they will be useful for diagnosis as well.
Next: What treatments are available for depression? »
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