When you're in a full-blown depressive meltdown, it can be extremely stressful even thinking about seeing a doctor.
Having experienced this myself, and struggled to get the help I needed at the time, I’ve outlined the procedure that many doctors use to screen whether or not you have depression.
This is so you can read through these questions and assess your own well being before taking that all-important step to seek medical help.
How Depression Is Diagnosed
There are several steps doctors take to assess your mental health. I’ve outlined these but they are in no particular order.
What Will The Doctor Ask Me? They Will Probably Start With Some General Questions
Your doctor may start off by asking you some general questions about your health. This is to assess exactly what direction he/she takes next.
If it’s apparent you may be suffering from depression, the doctor will want to delve a little more into your present circumstances and may ask you something like:
Has anything happened to you lately that might have affected you?
They will be trying to ascertain if you’ve suffered a loss like a job, bereavement, divorce or some other such life event.
Because depression is part of the grieving process, the doctor may well suggest that your feelings are a normal part of these life experiences.
Assuming that you’ve not encountered any of these hardships, he might move onto looking at your family background.
Does Depression Run In Your Family? If So, There’s A Higher Risk Of Depression For You
Experts are beginning to acknowledge that depression runs in families. One of the factors taken into account in how to diagnose depression is looking at your genealogy and previous episodes of mental health issues.
Two studies confirm that children of depressed parents could likely grow up suffering depression themselves.
How does a mother’s depression affect her children?
One study[i] looked at mothers and children and concluded:
“We find a strong bi-directional association between maternal depression and family experiences of adverse life events over the entire period the child is at home. After adjustment, children reared in a family experiencing high levels of adverse life events are more likely to experience a lifetime ever DSM-IV diagnosis of depression, are more likely to have experienced multiple episodes of lifetime ever depression, and are more likely to report their first episode of depression was at a younger age. “
How does a father’s depression affect his children?
Similarly, a study that attempts to look at the likelihood of children developing life depression and their fathers[ii] concluded:
“Our results show an association between depressive symptoms in fathers and depressive symptoms in their adolescent offspring. These findings support the involvement of fathers as well as mothers in early interventions to reduce the prevalence of adolescent depression, and highlight the importance of treating depression in both parents.”
The results in both studies showed a link between depressive symptoms in the parents and similar symptoms in their adolescent children.
The consensus is that if you have one parent with depression, you're three times more likely to suffer from depression yourself. If both of your parents have depression, your risk goes up to between four and five times more likely to suffer from depression.
Although the scientists are attempting to explain this by trying to identify a depressive gene, for anyone who has lived with a depressed parent, it’s much easier to explain.
Depressed people often live with:
Negative thinking
Limited self worth
Shame
Self neglect
Self-abandonment
Self critical thinking
The sad thing is that, as parents, no matter how much we try to hide these depression symptoms, it’s often not possible.
Consequently, this becomes the role model for the children and it’s how we learn to treat ourselves; it’s our framework for life. We then become depressed.
Do You Have Any Medical Problems? The Doctor Will Want To Know About Your Physical Health.
This is simply to rule out underlying medical conditions that can cause depressive symptoms.
Chronic Illness
A chronic illness can cause depression in some people. These can include:
Heart disease
Diabetes
Arthritis
Kidney disease
HIV and/or AIDS
Lupus
Multiple sclerosis
Hypothyroidism
Some studies say that if you suffer from a chronic illness and depression, having the two together can make both problems worse. Conversely, by treating the depression, the symptoms of the illness may improve.
Prescribed Drugs
Another tool for how depression is diagnosed is to look at the drugs being taken for chronic illness. Many drugs have depression listed as a side effect so your doctor may double check what’s been prescribed to you.
Examples of prescribed drugs that can cause depression are:
Isotretinoin for acne
Anticonvulsants for epileptic seizures
Barbiturates to prevent epileptic seizures
Benzodiazepines for anxiety and insomnia
Beta-adrenergic blockers or beta-blockers for heart problems or migraines
Calcium channel blockers for high blood pressure, chest pain, heart failure and other heart problems
Interferon alfa for certain cancers as well as hepatitis B and C.
NuvaRing with ehinyl estradiol/etonogestrel is used for birth control
Opioids to relieve moderate to severe pain
Statins for lowering cholesterol
Varenicline for smoking cessation.
Acyclovir for shingles and herpes.
What’s The Main Checklist The Doctor Uses To Diagnose Depression? It’s called the Hamilton Depression Rating Scale (HAM-D)
Little is known about the clinical relevance of the Hamilton Rating Scale for Depression (HAMD-17) and it’s widely known how unclear the final scores translate into the severity of someone’s depression.
In spite of this, this model tends to be the most widely used and respected diagnostic tool used by doctors.
It should be administered and evaluated by a clinician. However, it’s a useful guide to determine if the depression we experience is considered critical enough for us to seek treatment.
Add up your scores (to the left of each answer) as you go through the questions and the evaluation is at the end.
1. DEPRESSED MOOD
(Gloomy attitude, pessimism about the future, feeling of sadness, tendency to weep) 0 = Absent 1 = Sadness, etc.
2 = Occasional weeping
3 = Frequent weeping 4 = Extreme symptoms
2. FEELINGS OF GUILT
0 = Absent 1 = Self-reproach, feels he/she has let people down 2 = Ideas of guilt 3 = Present illness is a punishment; delusions of guilt 4 = Hallucinations of guilt
3. SUICIDE
0 = Absent 1 = Feels life is not worth living 2 = Wishes he/she were dead 3 = Suicidal ideas or gestures 4 = Attempts at suicide
4. INSOMNIA - Initial
(Difficulty in falling asleep)
0 = Absent 1 = Occasional 2 = Frequent
5. INSOMNIA - Middle
(Complains of being restless and disturbed during the night. Waking during the night.)
0 = Absent 1 = Occasional
2 = Frequent
6. INSOMNIA - Delayed
(Waking in early hours of the morning and unable to fall asleep again) 0 = Absent 1 = Occasional
2 = Frequent
7. WORK AND INTERESTS
0 = No difficulty 1= Feelings of incapacity, listlessness, indecision and vacillation 2 = Loss of interest in hobbies, decreased social activities 3 = Productivity decreased 4 = Unable to work. Stopped working because of present illness only. (Absence from work after treatment or recovery may rate a lower score).
8. RETARDATION
(Slowness of thought, speech, and activity; apathy; stupor.) 0 = Absent 1 = Slight retardation at interview
2 = Obvious retardation at interview 3 = Interview difficult 4 = Complete stupor
9. AGITATION
(Restlessness associated with anxiety.)
0 = Absent 1 = Occasional 2 = Frequent
10. ANXIETY - PSYCHIC
0 = No difficulty 1 = Tension and irritability 2 = Worrying about minor matters
3 = Apprehensive attitude 4 = Fears
11. ANXIETY - SOMATIC
Gastrointestinal, indigestion Cardiovascular, palpitation, Headaches Respiratory, Genito-urinary, etc. 0 = Absent 1 = Mild 2 = Moderate 3 = Severe 4 = Incapacitating
12. SOMATIC SYMPTOMS - GASTROINTESTINAL
(Loss of appetite, heavy feeling in abdomen; constipation) 0 = Absent 1 = Mild
2 = Severe
13. SOMATIC SYMPTOMS - GENERAL
(Heaviness in limbs, back or head; diffuse backache; loss of energy and fatiguability)
0 = Absent 1 = Mild
2 = Severe
14. GENITAL SYMPTOMS
(Loss of libido, menstrual disturbances)
0 = Absent 1 = Mild 2 = Severe
15. HYPOCHONDRIASIS
0 = Not present 1 = Self-absorption (bodily) 2 = Preoccupation with health 3 = Querulous attitude 4 = Hypochondriacal delusions
16. WEIGHT LOSS
0 = No weight loss 1 = Slight 2 = Obvious or severe
17. INSIGHT
(Insight must be interpreted in terms of patient’s understanding and background.)
0 = No loss 1 = Partial or doubtful loss
2 = Loss of insight
EVALUATION:
TOTAL ITEMS 1 TO 17: _______________
0 – 7 = Normal 8 - 13 = Mild Depression
14 -18 = Moderate Depression
19 - 22 = Severe Depression More than 23 = Very Severe Depression
[i] http://www.journalofpsychiatricresearch.com/article/S0022-3956(17)30027-4/fulltext
[ii] http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(17)30408-X/fulltext
REMEMBER I'M NOT A DOCTOR. THIS ARTICLE IS ONLY MY OPINION AND NOT A SUBSTITUTE FOR A MEDICAL EVALUATION.
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