In the past, medical and mental health professionals lumped all mood disorder diagnoses together. However, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now recognizes many different types of depression diagnoses and distinguishes between them. For example, major depressive disorder, bipolar disorder, seasonal affective disorder (SAD), and dysthymia are all subtypes under the diagnosis of depression.
The biggest hurdle to dealing with depression is getting a proper diagnosis. Because of all the different forms of depression and varying symptoms, you and your doctors can struggle to identify what is wrong. Some people with depression, especially adolescents, may be highly irritable or agitated. Others may exaggerate their eating and sleeping patterns, indulging too much or too little. If you are clinically depressed, you may withdraw and become apathetic. Or, you may be experiencing internal turmoil and feelings of hopelessness while your observable or behavioral symptoms are nonexistent. No one may know you are struggling.
The good news is that depression is treatable, but a correct diagnosis is the key to putting your symptoms into remission. Not seeking treatment or a misdiagnosis can be deadly. So how can you help your doctors uncover your depression?
The Initial Exam
Depression screenings are becoming more common, so you might fill out a form at your annual physical, if you have just given birth, or if you’re following up with an illness associated with depression. If the screening identifies you as at risk for depression, or you have already raised concerns about feeling depressed with your doctor, your general practitioner will conduct a physical exam, focusing on your neurological and endocrine systems.
They will interview you about your symptoms and order lab tests to rule out other physiologic reasons such as anemia, thyroid problems, vitamin deficiencies, and other hormone imbalances. They will need to know if you already have significant health concerns like cancer, central nervous system tumors, multiple sclerosis, previous head trauma or stroke, or syphilis contributing to your depression symptoms. If they think depression is the likely diagnosis, your doctor will refer you to a therapist, psychologist, or psychiatrist for further help.
The Complete Diagnostic Evaluation
Before seeing a specialist for a diagnosis, you should go over your potential risk factors for depression and prepare information to help them make an accurate diagnosis. You should make a list of your symptoms, abnormal behaviors you may experience, any illnesses you’ve had, and a complete family health history on each of your parents’ sides if possible.
Be sure to disclose all medications you are taking, including over-the-counter drugs, natural supplements, and any lifestyle habits such as alcohol consumption, other drug use, and smoking. Let your provider know if you are experiencing any social, work, or relationship stress in your life.
1. Risk Factors for Depression
Statistically speaking, women and members of the LGBTQ community, those with low self-esteem or suffering from a life-threatening or chronic illness are at risk for depression. Other risk factors include taking sleeping pills or other medications with depression warnings, substance use problems, living in regions with decreased sunlight, having other mental health disorders, or a family history of depression or other mental health problems.
However, it is important to understand that depression affects people of all genders, races, ethnicities, and age groups. If you have symptoms that are affecting your life, you should seek help from a qualified mental health provider.
2. The DSM-5 Diagnosis Criteria
For a provider to diagnose you with depression, you must have one of these two symptoms daily for a minimum of two weeks:
- No longer enjoying things that were pleasurable to you before
- Feelings of sadness or a depressed mood for most of the day
Additionally, you need to have a minimum of five symptoms below nearly every day, including the previous two in the overall count.
- Excessive sleep or insomnia
- Loss of energy or fatigue
- A significant change in appetite or weight (losing or gaining five percent or more within a month)
- Difficulty concentrating or making decisions
- Physical restlessness that is noticeable to others
- Feelings of hopelessness, worthlessness, or excessive guilt
- Recurring thoughts of passively dying or suicide, forming a suicide plan, or a suicide attempt
3. Physical Symptoms
While depression is a mental health issue, you may be experiencing some physiologic signs. They are often vague and associated with so many illnesses that they cannot be indicative of depression by themselves. Common symptoms include frequent headaches, digestion issues and abdominal discomfort, slowing body movements, and pain in your back, joints, or limbs.
Once you have a depression diagnosis, there are many treatment options available to you, including talk therapy, medications, and alternative depression treatments like accelerated TMS. Treating depression is highly individualized. One combination may work for one person but make no difference for you. Work together with your mental health professional to find the right treatment for you.
Depression is highly treatable but rarely resolves on its own. Left alone too long, it can wreak havoc on your life. It can cause trouble in your life, from work issues to relationship problems. If you suspect depression is the culprit or you are having suicidal thoughts, seek help immediately.