Diagnosis of Depression

by Amy Scholten, MPH

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Your healthcare provider will ask about your symptoms and medical history, and perform a physical exam. He or she can also perform a mental health evaluation and search for physical causes of depression. Your healthcare provider uses these findings to make the diagnosis. There is no blood test or specific diagnostic test for depression.

Depression is often diagnosed based on the following:

Initial Assessment—Your healthcare provider will ask about your symptoms: when they started, any triggering events, how severe they are, how they affect your daily activities, their association with chronic pain, whether you have had them before, and if so, whether the symptoms were treated and what treatment was given.

Physical Examination—Your healthcare provider will give you a thorough physical exam. Certain medications, as well as some medical conditions, such as viral infection, can cause the same symptoms as depression. Your healthcare provider can rule out these possibilities through a physical exam, interview, and lab tests. The physical exam may include a mental status exam to determine if your speech, thought patterns, or memory have been affected. This may indicate a neurologic cause of depression.

If a physical cause of depression is ruled out, a psychological evaluation can be done either by your healthcare provider or by referral to a psychiatrist, psychologist, or specially trained mental health professional.

Psychological Evaluation—A psychiatrist, psychologist, social worker, or mental health counselor can give you a psychological exam. You may take a special screening test for depression, such as the Beck Depression Inventory or the Hamilton Rating Scale. These tests have limitations, however, and must be interpreted in the context of your symptoms and personal situation.

You may also be evaluated for other psychiatric conditions that may coexist with depression, such as alcohol and drug abuse, anxiety disorders, and personality disorders.

References:

National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Revision. Washington, DC: American Psychiatric Association; 2000.

Depression. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/healthinformation/depressionmenu.cfm. Accessed March 24, 2007.