Depression

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideLearn to Spot Depression: Symptoms, Warning Signs, Medication

Learn to Spot Depression: Symptoms, Warning Signs, Medication

What specialists treat depression?

A variety of health-care specialists evaluate and treat people with this condition, including the following:

  • Primary-care providers like family doctors, internal-medicine practitioners, or geriatricians (physicians who specialize in treating the elderly)
  • Mental-health specialists, such as psychiatrists, clinical psychologists, social workers, pastoral or mental-health nurses, or other counselors
  • Primary care or mental-health prescribers, like physician assistants or nurse practitioners
  • Health-maintenance organizations
  • Community mental-health centers
  • Hospital psychiatry departments and outpatient clinics
  • Community support groups, often hospital affiliated
  • University or medical school-affiliated programs
  • State hospital outpatient clinics
  • Family service/social agencies
  • Private clinics and facilities
  • Employee assistance programs
  • Local medical and/or psychiatric societies

What tests do health-care professionals use to diagnose depression?

People who wonder if they should talk to their health professional about whether or not they have depression might consider taking a depression quiz or self-test, which asks questions about depressive symptoms. In thinking about when to seek medical advice about depression, the sufferer can benefit from considering if the sadness lasts more than two weeks or so or if the way they are feeling significantly interferes with their ability to function at home, school, or work and in their relationships with others. The first step to getting 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. As previously mentioned, the side effects of certain medications, as well as some medical conditions and exposure to certain drugs of abuse, can include symptoms of depression. Therefore, the examining physician should rule out (exclude) these possibilities through a clinical interview, physical examination, and laboratory tests. Many primary-care doctors use screening tools, symptom tests, 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 and under what circumstances/stressors?
  2. How long have symptoms lasted?
  3. How severe are the symptoms?
  4. Have the symptoms occurred before, and if so, were they treated, what treatment was received, and was it effective?

The doctor usually asks about alcohol and drug use and whether the patient has had thoughts about death or suicide. Further, the history often includes questions about whether other family members have had a depressive illness, and if treated, what treatments they received and which were effective. Professionals are becoming increasingly aware of the importance of exploring potential cultural differences in how people with depression experience, understand, and express depression in order to appropriately assess and treat this condition.

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 ruling out the presence of a number of physical disorders and in research on mental health and perhaps in the future they will be useful for the diagnosis of depression, as well.

Medically Reviewed by a Doctor on 12/1/2016

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