Depression Screening: Online And In-Person

By Sarah Fader |Updated April 1, 2022
CheckedMedically Reviewed By Richard Jackson, LICSW

Depression is a very common mental illness. These days, most of us know someone who has been affected by a type of depression, whether it is a friend, co-worker, or family member. Maybe even yourself.

If you have experienced depression, you are likely familiar with the persistent feelings of sadness, guilt, difficulty making decisions, and sleepless nights. You may recognize the increasing amount of time that you spend in bed, away from people and avoiding your usual responsibilities.

Depression Can Be Debilitating, But It Is Treatable

Major depression is one of the most common types of mental illness. According to Mental Health America, 17.3 million American adults are living with Major Depressive Disorder (MDD).

An additional 3.3 million American adults experience Persistent Depressive Disorder (PDD, or dysthymia), a chronic form of depression where an individual undergoes a low mood for several years but the symptoms are generally less severe.

Depression can be very debilitating and decreases your quality of life, but it is highly treatable. Even though it might seem like no one can help the way you are feeling when you are depressed, reaching out for help can make a big difference.

Following and maintaining your prescribed treatment can lead not only remission from mental illness but also empowerment. Once you know what you are dealing with and know that there are treatments that work, it can give you a whole new outlook if you experience future depressive episodes.

Depression Screening

If you are worried that you or someone you know is experiencing depression, there are both online and in-person depression screening methods that can help you get on the right track towards getting a diagnosis and working to find treatment that works best for you.

Many health care professionals use the PRIME-MD instrument for diagnosing mental illness. Patients can find the depression module, PHQ-9, which scores you on the DSM IV's depression criteria at Patient.info. This tool is not only used for mental health screening but also to monitor the severity of patients' depression and their response to treatment.

When screening for depression, health care professionals are going to look mainly for a depressed mood and/or a loss of interest or pleasure in normal activities for a period of at least two weeks. In addition, several other symptoms should be present. Mental Health America lists the following as symptoms of depression:

  • Depressed mood
  • Loss of interest or pleasure
  • Significant weight loss or weight gain
  • Difficulties with falling or staying asleep
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive guilt
  • Trouble concentrating
  • Thoughts of death or suicidal ideation

If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255, and is available 24/7. For more information regarding suicide prevention, visit the American Psychiatric Association’s website.

As part of the health screening, your doctor will likely conduct a physical exam to see if there are any underlying biological causes for your depression, tests to see if there is another medical condition that can explain your symptoms, and perform a psychological exam all to ensure a proper diagnosis.

The main difference between screening for MDD and PDD is that a patient with PDD shows a depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years. For children, it can be either depressed mood or irritability for much of the day over a one-year period.

Other forms of depression that develop in unique circumstances, as noted by the Mental Health Association of Maryland, are seasonal affective disorder, postpartum depression and premenstrual dysphoric disorder.

It is important to note the link between depression and other types of mental illness and behavioral health disorders such as eating disorders, substance use disorders and post-traumatic stress disorder. Post-traumatic stress disorder involves experiencing distressing symptoms following a traumatic event. Many individuals living with post-traumatic stress disorder also experience significant symptoms of depression and anxiety.

The US Department of Health & Human Services discusses the connection between mental health and substance use disorders. They state that 1 in 4 adults with serious mental illness also have a substance use problem. Mental health and substance abuse often co-occur as an individual uses drugs or alcohol to cope with overwhelming symptoms of mental illness. The US Department of Health & Human Services recommends someone facing both mental health and substance abuse challenges find behavioral health treatment to address both conditions, which includes rehabilitation, psychotherapy, medication, and support groups.

Depression Screening for Adults

While an online depression test can be a helpful tool, they should never replace proper diagnosis. Untreated mental illness can be dangerous, and so if you suspect you have depression you should make an appointment with your physician for an official diagnosis.

If you have your suspicions but still aren't sure, Mental Health America has a quick, free depression test on their website that helps assess depression symptoms as self-reported by yourself over the last two weeks. This is one of the quickest and easiest ways to determine whether what you are experiencing may indicate the presence of depressive disorder. Mental Health America recommends printing the results and bringing them to a health care professional who is trained to properly diagnose mental illness and help you find treatment.

Depression Can Be Debilitating, But It Is Treatable

Your physician might have questionnaires of their own for you to fill out that will help them accurately assess your symptoms.

As part of the next steps your physician will help you narrow down an appropriate treatment for your symptoms and individual circumstances. They consider factors like your family medical history, co-existing diagnoses, and whether you are currently on any medications before coming to a conclusion.

Depression Screening for Children

Unfortunately, depression can occur at almost any age. It affects the young, the elderly, and even children. Diagnosing childhood depression and other types of mental illness should be done by a professional, and there are often different criteria for childhood mental disorders compared to diagnosing adults.

There are also several tools and resources online that are geared towards parents who are concerned about their children. In most cases, these quizzes are meant to be taken by the parents on their children's behalf. There are also self-reporting tests for adolescents, including tools and resources used for monitoring depression symptoms in teen patients. It is important to keep in mind these are screenings and does not replace a diagnostic assessment by a mental health professional.

Depression Screening for the Elderly

It is suggested that when screening for depression in older patients, short self-reporting scales can be just as useful and can be simpler and easier for them to complete.

Another study, conducted by F. Lamers, C.C.M. Jonkers, H. Bosma et al. (2008) found that the PHQ-9 was reliable and valid when used to screen for depression in chronically ill elderly patients ages 60 and up.

Elderly patients concerned that they might be experiencing depression and their families can find an online version of the 30-item Geriatric Depression Scale, a screening tool, but it is important to follow up with a medical professional for official diagnosis at any age.

After Depression Screening and Diagnosis: Treatment

Studies have shown that depression is a highly treatable mental illness. According to Mental Health America, about two-thirds of people with major depression never seek appropriate treatment. That is why proper diagnosis is such an important first step. Next, patients and their physicians can create a strategic plan for treatment. Treatment options primarily include psychotherapy, medication, and support groups.

Behavioral health counseling can be beneficial for learning to cope with mental health issues. One will learn skills and techniques to incorporate healthy coping skills into their life. A common type of psychotherapy known as cognitive behavioral therapy, focuses on challenging unhelpful thought patterns to influence one’s mood and behavioral health. A paper published by R.J. DeRubeis, G.J. Siegle and S. D. Hollon (2008) shares that medication and cognitive therapy are equally effective in treating depression, with cognitive therapy showing the potential to reduce the risk of relapse even post-treatment. They suggest that better understanding the differences between medication and therapy in treating depression could lead to better future outcomes.

Behavioral health involves the connection between an individual’s body and mind. The focus of behavioral health is how one’s habits impact their mental and physical wellbeing. It is important to recognize the connection between one’s physical health and mental health. Strategies for managing depression include engaging in healthy habits such as following a nutritious diet, exercising regularly and prioritizing sleep.

Many individuals find it beneficial to participate in peer support groups to connect with others who can relate with the challenges of navigating mental illness. Research published by Mental Health America on peer support has proved its effectiveness in the field of behavioral health.

To find treatment from a licensed mental health practitioner, you can ask for a referral from your primary care physician or turn to an online directory or  find someone in your local area. If for some reason you can't attend therapy sessions or can't afford them, there are other alternatives.

One alternative for treatment services is turning to an online counseling and therapy service like BetterHelp. BetterHelp provides online mental health services that can be accessed online via your computer or mobile device. The set-up is easy. You simply fill out their questionnaire and BetterHelp matches you with a qualified counselor who is experienced at dealing with any mental health issues you may be facing.

BetterHelp and similar mental health services that provide counseling are great because they offer an ongoing relationship where patients have someone that they can turn to at any time. Users can also take part in phone sessions and therapy groups.

In addition to medication and therapy, lifestyle changes can also bring about a reduction in symptoms of mental illness and provide a sense of resilience against future depressive episodes. A few important lifestyle changes that you can make to fight against depression are embracing exercise and nutrition, getting better sleep, relying on a social support system (of trusted friends, family members, and/or an online community) and reducing the amount of stress in your life.

Conclusion

Depression is most often treated by primary care physicians, who should be aware of the symptoms of depression and make use of the screening tools that are available to them. Too often, patients go to their physician and report symptoms of depression that go unnoticed.

Symptoms like insomnia and hypersomnia, weight loss or weight gain, and inability to concentrate may not look like depression at first glance but knowledgeable health professionals should consider it as a possibility and screen patients to rule depression out.

If you suspect depression is the cause of your symptoms, bring it up to your doctor in case they overlook it.

After initial screening, patients may go through several other procedures to receive a full diagnosis and develop a strategic plan for treatment. Treatment options might include prescription medication or referring the patient to a mental health professional that will provide counseling.

Prompt screening and treatment can help reduce the symptoms of mental illness. It can provide patients with the skills to avoid, or at least cope better with, future depressive episodes. Both medication and psychological treatments have been proven effective in treating mental illness such as depression anxiety. In some cases, doctors may even prescribe a combination of the two to get symptoms under control.

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