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. 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 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. As previously mentioned, 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, symptoms 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? 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 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.

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.