Clinical Depression Test And Diagnosis: Understanding Mental Health Screening
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Sadness is a universal emotion that can be an appropriate response to challenges in life. Contrarily, depression is a severe mental illness characterized by sadness, low mood, and a lack of interest in previously enjoyed activities. It can sometimes be challenging to determine whether one is experiencing sadness or a more serious mental health concern. One way to understand the difference is by receiving a professional diagnosis or taking a depression test, which can be done in various ways.
What is a depression test?
A depression test is a screening questionnaire that asks questions about your thoughts, feelings, and behaviors over the past two weeks to screen for depressive symptoms and disorders. If you take a depression test online or on your own, it may not be an official or accurate result. Note that online tests do not replace a diagnosis from a licensed professional. Reach out for guidance from your primary care provider or a mental healthcare professional for further screening if you receive a positive result online.
Official depression screening tools
An example of an official depression screening is the Patient Health Questionnaire (PHQ-9), developed by Doctors Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues. The PHQ-9 assesses depression symptoms based on how a person describes the frequency with which they’ve been bothered by a series of problems in the last two weeks. The multiple-choice options span the following options:
- “Not at all”
- “Several days”
- “More than half the days”
- “Nearly every day”
A sample of the PHQ-9 is quoted below:
Over the last two weeks, how often have you been bothered by the following problems?
- Little interest or pleasure in activities
- Feeling down, depressed, or hopeless
- Trouble falling or staying asleep or sleeping too much
- Exhaustion or little energy
- Poor appetite or overeating
- Believing you are a failure or have let yourself or your family down
- Difficulty concentrating on daily tasks
- Moving or speaking so slowly that other people could have noticed
- Being more fidgety or restless than usual
- Thoughts that you would be better off dead or hurting yourself in some way
If the individual has experienced one or more of the concerns above over the last two weeks, they are asked how difficult those problems have made it for them to do their work, take care of tasks at home, or get along with others.
If you’ve been bothered by feelings, thoughts, or behaviors from the depression test above, or if you are wondering if you might be depressed, the most effective way to receive answers is by speaking to a mental healthcare professional. Support is available, and there are effective options for treating depression. Know that you are not alone. Many people experience depression. In 2020, 8.4% of adults in the US experienced a major depressive episode, equivalent to 21 million people.
Diagnosing depression
When diagnosing depression, healthcare professionals and other mental health providers can use multiple tools and tests to identify symptoms. If you’re looking up questions about whether you have depression, you might be at the point where reaching out for help could be valuable.
When you meet with a healthcare provider about depression, they’ll work with you to determine your diagnosis and the individualized treatment plan that may best suit your needs. In addition, they may perform the following diagnostic steps.
Discussing symptoms during a clinical depression test and diagnosis
When you first meet with a healthcare professional, they may ask about your symptoms and experiences as part of a clinical depression test and diagnosis. Topics may include:
- Your mood
- Lack of enjoyment or interest in previously enjoyed activities
- Change in weight or appetite
- Sleep patterns, such as insomnia (lack of sleep) or sleeping too much
- Loss of energy or feelings of fatigue
- Thoughts of worthlessness, hopelessness, or guilt
- Difficulty concentrating or making decisions
- Irritability
- Use or misuse of substances
- Chronic or significant stressors
- Challenges with functioning at home or work and in relationships
- Thoughts of self-harm
The healthcare provider might use a diagnostic test that addresses these symptoms or others. The National Institute of Mental Health explains that for depression to be diagnosed, symptoms must be present throughout the day for most days in a two-week period.
Evaluating physical symptoms
A mental health professional may also look at whether you are experiencing common physical symptoms of depression, like the following:
- Headaches
- Stomach aches or digestive symptoms
- Constant exhaustion
- Difficulty sleeping
- Slow physical movement
- Limb pain, joint pain, or back pain
Examining health history as part of mental health care
Before a diagnosis is made, your physician may ask you about your health history as part of mental health care, including the following details:
- Your physical and mental health history
- Your family history, including information about relatives who may have lived with or are currently experiencing mental health conditions
Performing lab tests
To evaluate possible physical contributors to depression, your doctor might order lab tests. Examples of contributors can include:
- Viruses
- Illnesses
- Medications
- Hormonal deficiencies or imbalances
- Vitamin deficiencies
Considering risk factors
Depression can affect anyone, but there are some common risk factors, including the following:
- Biochemistry: Certain chemicals in the brain may contribute to depression.
- Personality: People with certain personality traits (such as a pessimistic outlook, negative self-esteem, or a tendency to be stressed) may be more prone to depression.
- Genetics: Depression can run in families.
- Environment: Exposure to neglect, abuse, loss, violence, poverty, or other challenging conditions may contribute to depression.
Treatment options
If your healthcare provider diagnoses you with depression, they can work with you to develop an individualized treatment plan. A treatment plan may include medication, psychotherapy (talk therapy), or a combination of the two. Self-care is also often part of a treatment plan. Below are further examinations of these options.
Medication treatment for depression
Medications are often available to treat depression. However, medications must be prescribed by a medical doctor like your primary care physician or a psychiatrist. Consult your doctor before starting, changing, or stopping any medication.
Your doctor can work with you to find a medication that manages your symptoms and offers guidance about what to expect. Your doctor can also help you understand the possible side effects of medication. If you are taking medication, contact your prescribing physician with questions or concerns.
Therapy
Therapy, also called psychotherapy or talk therapy, can be a vital part of an effective treatment plan for depression. In therapy, you can work with a trained professional to learn to restructure thoughts to change habits that may contribute to depression. You may identify life events (past and present) that could be contributing to depression and find healthy ways to change them or accept them and move forward.
You might work on goal-setting and realistic, healthy ways to meet your goals. You might focus on developing healthy coping skills to manage symptoms and prevent and manage depression in the present and future. In this way, you can learn ways to have healthier, more positive thoughts and behaviors.
How to use self-care as a treatment for depression
While depression can make it challenging to take steps to help you feel better, taking care of yourself or self-care as a treatment has been proven to reduce some symptoms. Below are a few options to consider.
Connect with others
Depression may cause an urge to withdraw from friends and family and can seem isolating. However, staying connected with others—particularly those who make you feel safe and cared for—can offer you a sense of support. You might also find meaningful connections by volunteering, caring for a pet, or joining a support group.
Partake in hobbies
Depression can deplete your energy, but trying to partake in activities you used to enjoy, even if you don’t anymore, may be beneficial. While it may take some motivation to get going, you may gradually recognize how being active or out in the world can improve your mood and help you work through these symptoms.
Care for your physical needs
Regular, healthy sleep patterns may improve your mood. Eating a nutritious diet can also help manage depression, as can exercise and stepping outdoors.
Alternative support options for mental health care
There are alternative support options for mental health care that can help you manage depression. With the help of a mental health professional, you can find ways to control or lessen the severity of your depression symptoms, get to the root of the symptoms, and improve your emotional well-being. If you are interested in seeking help but commuting to an in-person appointment feels exhausting, one alternative option is online therapy through a platform like BetterHelp may be an option.
With online therapy, you can match with a therapist online and speak with your therapist virtually wherever is most comfortable if you have a reliable internet connection. Plus, research has found that online therapy can be an effective option for treating depression. For instance, one study concluded that an internet-based intervention for depression could be equally beneficial to regular face-to-face therapy.
Takeaway
How is a clinical depression test and diagnosis conducted?
A clinical depression test and diagnosis might involve several assessments that may be used to determine whether a person is experiencing a depressive disorder or measure the severity of a person’s depression. One example of a screening tool is the Beck Depression Inventory (BDI and BDI-II), which are questionnaires that are used in both clinical and research settings. The more commonly used clinical depression test, the BDI-II, contains 21 items in four symptomatic categories: Somatic, Affective, Cognitive, and Vegetative. The number of items a participant identifies with can indicate the severity of their depression. For example, those scoring between 10 and 18 may be living with mild depression, while individuals who score above 30 may be experiencing severe depression.
What are the 3 signs of clinical depression?
There are a variety of signs that a person may be experiencing clinical depression. Three important signs to look for may include:
Persistent Feelings of Guilt or Shame: Depression can often manifest as negative thought patterns, including those that revolve around shame or guilt. These shameful and guilty feelings may not be the result of any wrongdoing or based on reality. For example, some individuals may feel guilty even when they are having a good day.
Frequent Fatigue: While feeling tired can be a symptom of other conditions, depression also typically comes with chronic fatigue. These feelings can be exacerbated by other depression symptoms, leading one to lose interest in doing previously enjoyable activities.
Suicidal Ideation: One of the most serious signs of depression is thoughts of suicide or self-harm. If you or someone you love is experiencing suicidal ideation, it’s essential to reach out for help immediately. One helpful resource is the Suicide and Crisis Lifeline, which can be reached by dialing 988 and is available 24/7.
Is clinical depression normal?
According to the World Health Organization (WHO), depression affects 3.8% of the global population, including 5% of adults (5.7% are over the age of 60). In addition, 4% of men and 6% of women are affected by depression. Clinical depression is a common mental health disorder that can affect anyone. However, it may be difficult for individuals experiencing depression to receive treatment. In fact, the WHO estimates that 75% of people in low- and middle-income countries receive no treatment for their depression whatsoever. This is due to a variety of reasons, including mental health stigmas, a lack of available care, and an inability to pay for treatment.
To help identify symptoms in a patient, healthcare professionals often rely on validated scales like the Center for Epidemiologic Studies Depression Scale (CES-D) to measure depressive symptoms. In some cases, a family member may encourage a patient to seek help when signs of distress become noticeable.
What is true clinical depression?
While there may not be a clinically defined “true” type of depression, clinical depression (also known as major depressive disorder or major depression) is a common mental health disorder. This disorder is considered one of the more serious depressive conditions, with symptoms that may impede an individual's ability to function in their lives. These symptoms can vary but may include:
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How do I know what type of depression I have?
The only way to know what type of depression you have is to visit a medical professional and get an official diagnosis. These healthcare providers can determine what type of depression you are experiencing by looking at your and your family’s medical history, assessing your symptoms, and ruling out any other conditions that may result in a misdiagnosis. From there, they will see which depressive disorders you fit the criteria for. These disorders can vary and may include major depression, seasonal affective disorder, or postpartum depression. After that, a doctor will help you create a treatment plan to address your symptoms and potentially find relief.
As a first step, professionals may use tools like the Patient Health Questionnaire, Hamilton Depression Rating Scale, or Geriatric Depression Scale to measure your symptoms. These scales can help assess your depressed mood and other indicators of mental health. In some cases, a Beck Depression Inventory or CES-D (Center for Epidemiologic Studies Depression) scale may be used, especially in research or when screening the general population. These assessments can contribute to an accurate diagnosis and support the development of a clinical diagnosis based on diagnostic criteria in the DSM-IV or its fifth edition. These methods are commonly backed by meta-analyses and may be valuable for both patients and their care providers.
Is clinical depression genetic?
According to Stanford Medicine, heritability for clinical or major depression is approximately 40%-50% and may be higher for severe depression. Their research indicates that individuals with a parent, sibling, or family member with major depression may be at 2 or 3 times greater risk of developing a depressive disorder. In addition, Stanford Medicine estimates that, in most cases of depression, nearly 50% of the cause can be tied to genetics, while the remaining 50% is related to psychological or physical factors, including abuse, childhood neglect, and chronic stress. To support this, various rating scales such as the Hamilton Depression Rating Scale or Patient Health Questionnaire are often used to help evaluate depressive symptoms across the general population. These tools may also assist in identifying symptoms in higher-risk groups, including those with geriatric depression, and can contribute to a more accurate diagnosis. However, it's important to note that Stanford Medicine notes that further research and large-scale meta-analyses are needed to fully determine the role that genetics plays in depression, especially when applying a clinical diagnosis based on established diagnostic criteria.
What are the 4 criteria used to diagnose depression?
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a person diagnosed with depression must experience either a depressed mood or a loss of pleasure or interest (anhedonia) in addition to four or more other symptoms within a two-week period. These symptoms may include:
Significant unintentional weight loss or gain (including changes in appetite)
Feelings of fatigue or a daily lack of energy
Thoughts of worthlessness or unnecessary guilt
Challenges with cognition, including slow thought processes
An objective reduction in physical movement
Suicidal ideation or persistent thoughts of death
Is clinical depression lifelong?
Depressive episodes may last anywhere from two weeks to several months. In some cases, particularly those relating to persistent depressive disorder, depressive episodes may last for several years. As for clinical depression itself, often associated with a clinical diagnosis made using diagnostic criteria outlined by the American Psychiatric Association, there is no known cure, which means most individuals who experience depression will have the disorder their entire lives. However, some treatments may reduce the severity of symptoms and frequency of depressive episodes. For example, depression screening instruments such as the Beck Depression Inventory II, Patient Health Questionnaire (PHQ-9), or the Hamilton Depression Rating Scale are commonly used tools in mental health and primary care settings to monitor depression symptoms.
Some of these tools also help with measuring depression and identifying moderate depression, and they may track physical signs such as fatigue or weight gain, particularly in the adult population and older adults. In some cases, these treatments are so successful that they can cause depression to go into remission, during which it is asymptomatic. Mental health professionals may continue to monitor treatment using a structured rating scale such as the CES-D Scale or the Geriatric Depression Scale, especially for geriatric depression in primary care settings.
Who has clinical depression?
While anyone can develop clinical depression, the World Health Organization reports that women are more likely than men to have depression. This may be due to a number of reasons, including biological factors that may cause varying hormone levels in women. These hormonal changes can happen at multiple points in a woman’s life, including during puberty, before menstruation, during and after pregnancy, and before and during menopause. In addition, women may be subject to discrimination due to their gender, which may exacerbate symptoms of depression or increase the likelihood that a depressive disorder will develop. However, it's important to note that depression can affect people of any gender, and the symptoms of depressive conditions may be similar for many depressed individuals.
What is the most common type of clinical depression?
One of the most common forms of depression is major depressive disorder, also known as major depression. As of 2021, it is estimated that 21 million adults (8.3%) in the United States have experienced at least one major depressive episode in their lifetimes. The prevalence of major depression was higher for females (10.3%) than males (6.2%) and was more common for those between the ages of 18-25. Despite some portrayals in popular culture, major depression isn’t just about “feeling bad.” This disorder can have severe symptoms, including suicidal ideation, chronic fatigue, frequent sleep disturbances, changes in appetite, and persistent negative thought patterns.
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