What Is A Clinical Depression Test? Understanding Depression Screening

Sadness is a universal emotion that can be an appropriate response to challenges in life. Contrarily, depression is a mental illness characterized by low mood, fatigue, feelings of hopelessness, and/or 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 possible way to determine the difference is by completing a depression test, which can be done in various ways. A licensed mental health professional who specializes in depression testing can help you interpret depression test results.

What is a depression test?

PHQ-9: A quick, free depression screening tool

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 is one of the quickest and easiest ways to explore symptoms of depression. It is designed to take five minutes to help people assess their symptoms and decide if they want to see a professional to be evaluated. However, it is not designed to provide an official diagnosis.

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 provided below:

“Over the last two weeks, how often have you been bothered by any of the following problems?

1. Little interest or pleasure in doing things. 
2. Feeling down, depressed, or hopeless.
3. Trouble falling or staying asleep, or sleeping too much.
4. Feeling tired or having little energy.
5. Poor appetite or overeating.
6. Feeling bad about yourself—or that you are a failure or have let yourself or your family down.
7. Trouble concentrating on things, such as reading the newspaper or watching television. 
8. Moving or speaking so slowly that other people could have noticed. Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual.
9. Thoughts that you would be better off dead or hurting yourself in some wa.y”

If you have experienced one or more of the concerns above over the last two weeks, you are then asked how difficult those problems have made it for you to do your work, take care of tasks at home, or get along with others. 

Note: The PHQ-9 is free and widely used to help assess symptoms of depression. An official copy online should include a Pfizer Inc. copyright notice. It can be best to avoid using any personally identifiable information when taking the PHQ-9 and to avoid posting results online. Also, it’s recommended that readers not change the wording when helping another person use the instrument. 

What depression scores can and cannot tell you

A self-administered depression test may give you a score that indicates that you could be experiencing depression. However, a score within a certain range doesn’t automatically mean that you have depression, as tests cannot provide a diagnosis without a medical or mental health professional. These instruments are intended to help you get an idea about the different ways depression can affect you and decide whether you would like to speak with a healthcare or mental health professional for a formal evaluation. 

Diagnosing depression: Who should you talk to first?

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. If you are wondering where to get a diagnosis, you might start with a doctor who practices general internal medicine, such as a primary care provider. You could also consult a mental health professional, who may assess your symptoms and refer you to a doctor or psychiatrist for an official diagnosis and possible treatment with medication, as only certain licensed providers can prescribe medication.

When screening for depression, healthcare professionals and other mental health providers can use multiple tools and tests to identify symptoms. 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.

(If you are experiencing thoughts of self-harm or suicide, immediate help is available at the 988 Suicide & Crisis Lifeline. A counselor can assess active vs. passive risk, which typically refers to thoughts about not wanting to live vs. having a plan for suicide. Regardless of your specific thoughts, you can find immediate help by calling or texting 988.)

According to the National Institute of Mental Health, for depression to be diagnosed, symptoms must be present throughout the day for most days in a two-week period. For this reason, a healthcare provider might use a diagnostic test that asks about these symptoms and their duration. 

Evaluating physical symptoms 

A mental health professional may also look at whether you are experiencing common physical symptoms of depression, such as the following: 

• Headaches.
• Stomachaches 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, 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, low 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. 

Medication for depression

Medications are often available to treat depression. However, medications must be prescribed by a healthcare provider, 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 without causing too many side effects. 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 and change habits that may contribute to depression. You might 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. 

During therapy, you might also work on goal-setting and find 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 future. 

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, 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. 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.

Engage in hobbies 

Depression can deplete your energy, but trying to partake in activities you used to enjoy 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 your 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 time spent 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.

With online therapy, you can match with a therapist online and speak with them virtually from wherever is most comfortable if you have a reliable internet connection. You can communicate with your therapist via audio, video, live chat, or a combination of these methods.

Additionally, research has found that online depression therapy can be an effective option for treating depression. For instance, one systematic review and meta-analysis concluded that online therapy for depression could be at least as effective as regular in-person therapy.