Depression scales: definition, types, and uses

It can be used by an individual to help them decide whether it may be time to seek evaluation and treatment advice from a mental health professional. It can also be used by clinicians to help them understand the scope and intensity of symptoms in an individual so they can determine what course of action to recommend for them. Though it’s typically not a diagnostic tool in and of itself, a depression scale can aid in the diagnostic process. Below, we’ll discuss the various types of depression scales, the differences between them, and when they should each be used, plus what to do if you’re experiencing symptoms of a mental health condition like this.

What are depression scales?

Depression scales are often used to determine whether diagnostic measures and/or additional care may be necessary for an individual experiencing symptoms. You may be asked to complete a depression scale when you visit a therapist or psychiatrist for the first time. Or, your primary care provider may ask you to complete one if they feel that the mental and/or physical symptoms you’re experiencing could be related to depression.

Depression scales typically take the form of scored questionnaires. They’ll usually list a series of symptoms, and the individual taking the test will choose the frequency or severity with which they experience that symptom. At the end, the individual or the clinician administering the test will add up the ratings and see what their score indicates. For example, the Patient Health Questionnaire-9 (PHQ-9) is a depression scale that will result in a score between 0 and 27. The higher the score, the more severe symptoms of depression may be. 

Depression scales can also be used during treatment to measure the progression of symptoms. If you’re undergoing treatment for depression, you may be asked to complete a scale regularly. This practice can help your doctor or therapist determine whether the treatment has been effective, or if changes in the plan need to be made.

Who should use a depression scale?

Anyone can use a depression scale to see whether the symptoms they’re experiencing could potentially indicate a mental illness like depression. If so, they can seek the appropriate professional attention. Note that there are different depression scales for different demographics, such as people who are parents or the elderly. The reason for this is that symptoms of a mental illness like depression can manifest differently based on various factors such as age. For example, a 13-year-old will likely experience considerably different depression symptoms than a 65-year-old. 

It’s important to remember that only a qualified healthcare professional can make an accurate, clinical diagnosis of a mental health condition like depression. When used by an individual, a tool like a depression scale is simply intended to help them see if what they’re experiencing could potentially indicate the presence of a mental health condition. Regardless of the results of the scale, it’s generally recommended that you seek the support of a licensed healthcare professional if you’re experiencing symptoms of a mental health condition like depression.

When to use a depression scale

You may use a depression scale yourself or ask for a screening from a professional if you think you could be experiencing symptoms of depression. Common symptoms of depression include low mood, lack of energy, loss of interest in activities once enjoyed, changes in appetite, and disruptions in sleep patterns. While the presence of these symptoms does not definitively signal the existence of a depressive disorder, they could help you decide to pursue further screening—particularly if the symptoms are persistent and/or are negatively impacting your life and functioning.

You can access a variety of different depression scales by doing a quick internet search, and most take very little time to finish. Once you’ve completed a scale, you can bring the results to a medical or mental health professional. They may take them into account when evaluating your symptoms and determining whether you may need further care.

Types of depression scales

Understanding the different depression scales and who they were each designed for can help you determine which one may give you the most accurate view of your symptoms. Choosing the right depression scale is usually a matter best left up to the doctor or clinician who is administering the assessment. However, if you want to take an assessment to measure your symptoms at home, the most commonly recommended tool is the Hamilton Depression Scale. 

Remember: Depression scales can be helpful self-report tools, but they are not substitutes for seeing a doctor, psychiatrist, or other healthcare professional for a clinical evaluation. A professional can administer and/or interpret the results of a scale and help you understand what they mean. If you’re eventually diagnosed with depression, they can also develop a treatment plan to address your specific symptoms. See below for different types of depression scales and who they’re each intended for.

Hamilton Depression Scale

Originally published by Max Hamilton in 1960, the Hamilton Depression Scale is perhaps the most widely used depression scale. Typically consisting of 17 to 29 items (depending on the version), the scale is used to assess potential depression severity in the general population. In a meta-analysis spanning nearly 50 years, researchers concluded that the Hamilton Depression Scale has been, and continues to be, a reliable and consistent way to evaluate symptoms of depressive disorders. Recent research has further supported the validity of this depression scale.

CES-D Scale

The CES-D Scale stands for Center for Epidemiological Studies-Depression scale. This 20-question survey is another measure of depression severity for the general population. Several studies have been conducted to confirm the accuracy of the CES-D. For example, one study found that the CES-D was acceptable for use in high school and college students, and another concluded that the scale is accurate for the general population.

In addition, more recent research has continued to examine and confirm the reliability of the CES-D scale in different groups.

Geriatric Depression Scale

The Geriatric Depression Scale was developed to help measure depressive symptoms in older adults. The original scale had 30 questions, but an equally effective short form of the scale has been designed with only 15 yes/no questions. This scale is important because its questions can help measure depression while taking into account symptoms of Alzheimer's or dementia that some people in this age group may also experience.

Edinburgh Postnatal Depression Scale

The Edinburgh Postnatal Depression Scale was developed as a screening tool to evaluate symptoms in parents who have recently given birth, their partners, or adoptive parents who may be living with postnatal depression. Some experts recommend that parents complete this assessment before and after giving birth. 

Calgary Depression Scale

The Calgary Depression Scale was developed by Dr. Donald Addington with the University of Calgary specifically for individuals with schizophrenia because most depression scales do not distinguish between symptoms of depression and the negative symptoms of schizophrenia. Research indicates that this scale has high reliability and consistency. 

Reynolds Adolescent Depression Scale

The Reynolds Adolescent Depression Scale was developed by Dr. William Reynolds in 1987. Since that time, it has been one of the primary scales used to measure depression in adolescents. A revision of the scale was done in 2002, which has been shown to be even more effective than the original version. The Reynolds Adolescent Depression Scale has 30 items that help identify depression in young people, typically those aged 11 to 20. This scale has been used widely internationally.

Seeking support for symptoms of depression

Whether you’ve used a depression scale or not, seeking the support of a mental health professional is typically recommended if you’re experiencing symptoms of depression. A therapist, for example, can evaluate your symptoms and suggest a course of action. If you’re having trouble locating a provider in your area or would simply prefer to meet with someone virtually from the comfort of home, you might consider online therapy. Research suggests that virtual therapy can be an effective method for treating depressive disorders. In one study, for example, researchers found that online cognitive behavioral therapy could significantly decrease symptoms of depression. The study also specifically mentions the ability of online therapy to address the treatment gap that exists due to factors like geographic limitations, high cost, and time constraints.

Online therapy can be a convenient, accessible way to receive mental health care. With an online therapy platform like BetterHelp, you can discuss any symptoms you’re experiencing with a professional remotely, which can be useful if you don’t have mental health providers near you or can’t travel to and from in-person appointments. After completing a brief questionnaire about your needs and preferences, you’ll be matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging to address the challenges you may be facing.