- The body
It’s important for medical professionals to play close attention to those that might have depression. This could include many different types of individuals, including those who are seeking care for a chronic illness or for a simple annual check-up, or those visiting a medical professional when pregnant or for a postpartum check-up.
To diagnose and treat depression, a medical professional must have a clear understanding of the signs and symptoms a person is experiencing. There are series of standard questions used to screen for signs of depression.
A physical exam can reveal the overall physical state of the patient’s health, but talking with the patient is key to understanding why depression might be occurring and to determine the best way to treat the depression. However, some patients don’t show the commonly known symptoms of depression like daily moods, lifestyle habits, and behaviors, which can make the diagnosis difficult.
Mental health professionals are careful with evaluating patients for depression. If you are asking yourself questions like “Am I depressed?” or “Do I have depression?”,make sure to consult a doctor for a professional diagnosis and advice.
The job of experts is to gather all of the important information about a patient before making a depression diagnosis. This could be through medical evaluation, clinical interview, and additional assessments. Based on this, they can better evaluate whether you are experiencing depression.
In order to decide on the right treatment for depression, doctors can also use specialized tests or other laboratory measures. These help to make a conclusive diagnosis and choose a proper course of treatment. One of the most important tools when it comes to diagnosing depression is actually the conversations with the patient.
According to the Diagnostic and Statistical Manual of Mental Disorders, the symptoms of depression fall into four categories:
- Affective or mood symptoms. These include feelings of guilt, worthlessness, and a depressed mood.
- Behavioral symptoms. Behavioral symptoms include agitation and social withdrawal.
- Cognitive symptoms. These include difficulties thinking, making decisions, and concentrating.
- Somatic symptoms. Also known as physical symptoms, these include insomnia and hypersomnia (sleeping too much).
The above mentioned manual is used as a tool used to guide diagnoses by mental health professionals. Additionally, this tool is commonly used to help professionals communicate and converse with other medical professionals. It is used for sharing opinions and to help experts reach a consensus on which symptoms fit under which diagnosis.
Types of Mood Disorders
Mood disorders can be grouped into multiple categories. These include:
- Major depressive disorder
- Bipolar disorder
- Dysthymic disorder
- Substance-induced mood disorder
- Cyclothymic disorder
- Mood disorder due to a general medical condition
Additionally, there are two other sub-disorders, including 1) seasonal affective disorder and 2) postpartum depression. When treating a patient that expresses signs of depression, professionals use specific criteria to help determine the correct type.
Once all evaluations are complete and a diagnosis is determined, specifiers are used to give more detailed information about the diagnosis. These are used by the mental health professionals to get additional information about the patient, and to help them determine the most effective treatment and in predicting the course of the disease. For example, specifiers can be used to determine the severity of the symptoms, symptom frequencies, and provide details for treatment.
Diagnoses can look alike on the outside, but no two people experience the same symptoms. Therefore, specifiers are used to provide more details of the individual’s unique experiences. Specifiers of depression can include:
- Mild. Used to describe the presence of few symptoms, in cases where a patient can function normally with some extra effort.
- Moderate. Symptoms are somewhere between mild and severe.
- Severe with psychotic features. A person may be experiencing delusions and hallucinations. Researchers have shown that up to 15% of those with major depressive disorder may develop psychoses at some point. The presence of hallucinations can interfere with the ability to function and make sound judgments. These symptoms are serious and require immediate medical attention. In some cases, hospitalization may be needed.
- Severe without psychotic features. This is used to describe instances when an individual is not able to function or has little ability to function. When a manic episode occurs, a patient may need supervision to avoid harming themselves or others.
- Single Episode. The first episode of depression is considered to be the single episode.
- Recurrent episodes. The subsequent episodes after the first, single episode.
- Full remission. Full remission occurs when symptoms are absent for a minimum of two months.
- Partial remission. Partial remission occurs when there are no depressive episodes for a period of time less than two months.
- Chronic. Chronic depression is when a patient suffers from major depressive episodes for at least two years.
- Catatonic features. These include unusual movements or behaviors, such as excessive, purposeless activity, immobility, mimicking words and behaviors of others, and rigid posture.
- Atypical features. These include substantial weight gain or increase in appetite, excessive sleeping, and persistent sensitivity to rejection.
- Melancholic features. Melancholic features include a loss of pleasure in previously enjoyed activities, an inability to improve one’s mood, worsening of mood in the morning, waking up excessively early, slowed movements, substantial weight loss, and feelings of guilt.
- Seasonal pattern. A pattern of episodes in major depression or bipolar disorder that happen at particular times of the year.
- Postpartum onset. Postpartum onset is when episodes start within the first four weeks of giving birth.
- Rapid-cycling. Rapid cycling is when a person has a minimum of four recurring episodes within a 12 month span.
Depression can debilitating and can significantly decrease one’s ability to function and their quality of life. While there is no cure for depression, treatment has been shown alleviate symptoms and can lead to great improvements. If you are experiencing symptoms related to depression, it’s important to consult a medical professional to get the care you need.
To learn more about depression, please visit the links below:
- Mayo Clinic (2018). Depression (major depressive disorder). https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013
- National Institute of Mental Health (2018). Depression. https://www.nimh.nih.gov/health/topics/depression/index.shtml
- Mitchell, A. J. (2009). Clinical diagnosis of depression in primary care: A meta-analysis. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60879-5/fulltext