Duck Syndrome

Due to the informality of this diagnosis, there are no formal diagnostic criteria associated with duck syndrome. However, symptoms that have often been described include appearing placid on a superficial level ("above water") while frantically yet covertly ("under water") failing in one's attempts to keep up with the real or imagined excessive demands (to keep from "drowning"). Other often-described symptoms associated with duck syndrome include feeling that everyone else is doing, feeling, or being well compared to oneself, or that others are scrutinizing or perhaps even designing the situation to test their performance.

Since duck syndrome is not a formal diagnosis, it is the underlying depression, anxiety, and any other mental-health problem that would be assessed.

Depression or anxiety are associated with a number of other mental-health conditions, like attention-deficit hyperactivity disorder (ADHD), bipolar disorder, posttraumatic stress disorder (PTSD), and thought disorders like schizophrenia, so the evaluator will likely screen for signs and symptoms of manic depression (bipolar disorder), a history of trauma, and other mental-health symptoms. The depression or anxiety that is usually associated with duck syndrome also may be associated with a number of medical problems, or it can be a side effect of various medications, exposure to drugs of abuse, or other toxic substances. Therefore, routine laboratory tests are often done during the initial assessment to rule out other causes of symptoms. Sometimes, an X-ray, scan, or other imaging test may be needed. As part of the evaluation, the sufferer may be asked a series of questions from a standardized symptom survey or self-test to help determine the risk of suicide.

A number of mental-health practitioners tend to evaluate an individual who is thought to have duck syndrome. Such professionals include licensed mental-health counselors, pediatricians, other primary-care providers, specialists who treat patients for a medical problem, emergency-department doctors, psychiatrists, psychologists, psychiatric nurses, nurse practitioners, physician assistants, and social workers. These professionals will likely perform or refer for a thorough medical evaluation as part of assigning the correct diagnosis.