How Depression Is Diagnosed

Being depressed is difficult. And understanding what a doctor means when discussing it can confuse you and make things even harder to understand. If you aren’t sure what your doctor means, the information is harder to process. This makes it more difficult to ask the right questions, which is important to your care.

If your provider has diagnosed you with a depression disorder such as major depressive disorder, the terms they use may confuse you or you may not really be familiar with what they mean. In order to better communicate with your health care providers, you need to be familiar with the language they use. Here is more about how depression is diagnosed and some terms and language you should know so you get the help you need.

How Does My Doctor Know I’m Depressed?

Sometimes people confuse sadness and grief with depression. While they might seem the same, they’re not. For example, you might lose a long-term job, suffer the loss of a loved one, or experience a broken heart. These events may make you feel as if you have severe depression, when in actuality, they are happenings that cause temporary sadness. We’ve all heard someone say something like, “I’m so depressed that I lost my job.” Or, “My boyfriend left me, and I feel depressed.” While these things that happen make us sad, this is not the same as clinical depression.

And while a major disaster or event can cause PTSD and depression, some mistake feelings of sadness for actual clinical depression. There are many differences. And it’s not as though people set out to lie about their feelings because depression, sadness, and grief have similarities.

You may notice that characteristics of sadness and depression have similar attributes. Yet, they have major differences. For example, the American Psychiatric Association mentions that with grief, a person doesn’t lose their self-esteem or sense of worth. Both show depression, not sadness.

In fact, with major depressive disorder (MDD), we often combine the feelings of extreme sadness with a lack of self-worth or even self-loathing.

The National Institutes of Health writes that Major Depressive Disorder “causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.” These symptoms must be present for at least two weeks in order to be diagnosed with depression.

Your Doctor Finds Answers

You might wonder why your doctor has so many questions. This is so they determine if what you have is depression. As mentioned, sadness and depression are two different diagnoses. Yet, grief does sometimes cause depression, so the doctor needs to find out what is going on. And this is crucial because, while the symptoms may be similar, grief and depression have different treatment methods.

How a health care provider helps find answers is often with a specific diagnostic tool. There are different ones, but a common one is the Hamilton Rating Scale for Depression-17 This tool pinpoints 17 elements of depression in relationship to your symptoms, behavior, and mood.

There are certain questions they ask you that include variations of the following:

• Do you have trouble with work or working?
• Are you feeling depressed? This includes feeling helpless, hopeless, or sad.
• Do you have trouble sleeping? This includes insomnia at various times. For instance, in the middle of the night, early in the night, the early hours of the evening.
• Are you feeling guilty for no reason?
• Have you had thoughts about hurting yourself or suicidal thoughts?

The doctor will then look at and rate your answers for each of the 17 elements. For example, a score of zero means no symptoms related to that question. Let’s say that the doctor asked you if you have problems with work or with working, and you answer that you do not. That would be a zero rating. The scores increase with the severity of the answer.

The doctor or health care provider then adds up your score. First for each item, then a total. Using the HAM-D17 depression severity rating scale, they will be better able to make a recommendation whether they suggest treatment. The rating is:

• 0-7: No Depression
• 8-13: Mild Depression
• 14-23: Moderate Depression
• 24+: Severe Depression

Treatment Options

One thing to know about depression is that treatment options can be complex. The focus is to not only treat the issue but to lower your score on the HAM-D17 depression severity rating scale. This is not as simple as taking a pill or having a meeting where you discuss what is wrong. Instead, there is more the health care provider will need to discuss.

For example, here are a few key points your doctor will want to know more about.

• Family history
• Medical history
• Personal history
• The prescriptions you take or took in the past
• Any psychiatric history

That is a sample; each doctor may differ in what they ask and what kind of information they deem relevant. In fact, there is a deeper insight into those samples. According to Psychiatry Online, for a complete psychiatric assessment, the following is needed:

• History of the present illness and current symptoms
• Psychiatric history, including symptoms of mania, current and past treatments (including duration and dosages), and responses to treatment
• General medical history
• Medications, including prescribed and over-the-counter agents and supplements
• History of substance use and treatment for substance use disorders
• Personal history (e.g., psychological development, response to life transitions, major life events)
• Social, occupational, and family histories

As you can see, the information is similar, yet more in-depth.

Inpatient or Outpatient?

Your doctor will make a suggestion whether to consider inpatient treatment or outpatient treatment. Your doctor chooses an initial treatment plan, which may include medication and/or counseling. They take a variety of considerations when choosing your treatment plan. For example, the doctor will most likely ask you if you prefer outpatient treatment. This means you stay home and have day treatment in a facility instead of being in a 24/7 hospital or other facility setting. They will also consider prior treatment methods, if any. For instance, if you have tried outpatient treatment in the past and it did not help, you might consider inpatient treatment.

Other things taken into consideration include whether there are co-occurring disorders. Environmental, psychological, and biological factors get considered too.

Therapy is one of the most important types of treatment methods for a depression diagnosis. One method is cognitive behavioral therapy. Group, family, and couples therapy are other types that help those with depression. And some use methods like holistic healing to help. But keep in mind that you get out of therapy what you put into it. If you’re not comfortable opening up to someone about your problems, then it may be harder to help you heal through talk therapy alone.

Last, there are medications that help with depression. There is no set cure-all for this disorder, and sometimes it is hard to find the right medication or combination of medications. This may discourage you but hang in there. Some doctors use what they call the GeneSight Psychotropic test. This is for those who have difficulty with medication for depression, and it provides genetic insight that helps choose what is best.

Some people do best with a combination of different therapies, while others may do well with just counseling or medication. It all depends on the person.

Get the Help You Need

The most crucial thing after being diagnosed with depression is to get the help you need. Whether you feel more comfortable with outpatient counseling, take the proper medications, or feel that an inpatient environment is more beneficial — addressing the problem is the first step in healing.

At Transformations, we have a varied treatment program for those diagnosed with depression. Our counselors and staff provide compassionate care and a healing atmosphere. If you need help with your depression, reach out to us so we can help you get started on your new journey.