Any depression diagnosis starts with your doctor checking your health history. They will quiz you about your health as sad feelings may be triggered by an underlying health problem. It is imperative to undergo a physical examination to rule out pathological causes or any other incidental physical problems.
This includes blood or urine tests to rule out other conditions, such as an underactive thyroid (hypothyroidism), and then a psychological assessment. Your doctor may ask you to take a test or fill in a questionnaire.
Doctors assess depression by asking how serious it is:
- Mild depression has a small impact on your daily life
- Moderate depression has a major impact on your daily life
- Severe depression makes it almost impossible to get through daily life – a few people with severe depression may have psychotic symptoms
With dysthymia, your doctor will want to make sure that the symptoms are not a result of substance abuse or a medical condition, such as an underactive thyroid (hypothyroidism).
To be diagnosed with clinical (major) depression, you must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. For clinical depression, you must have five or more of the symptoms over a two-week period, most of the day, nearly every day.
How can a psychiatrist help you?
If your doctor thinks you may have bipolar disorder, they will usually refer you to a psychiatrist. If your illness puts you at risk of harming yourself, it is advised to make an appointment immediately.
During the psychiatric assessment, you will be asked about your symptoms and when you first experienced them. The psychiatrist will also ask about how you feel leading up to and during an episode of mania or depression, and if you have thought about harming yourself.
They will also want to know about your medical background and family history, especially whether any of your relatives have had bipolar disorder.
If someone else in your family has the condition, the psychiatrist may want to talk to them.
Depending on your symptoms, you may also need tests to see whether you have a physical problem, such as an underactive thyroid or an overactive thyroid.
If you do have bipolar disorder, you will need to visit your doctor regularly for a physical health check.
What should you know about suicidal feelings?
It is important to remember that mental disorders, particularly depression and substance abuse, are associated with more than 90% of all cases of suicide.
Some of the warning signs that people with depression are considering suicide are:
- Self-harm
- Talking about death or suicide
- A sudden lifting of mood (this could mean that a person has decided to commit suicide and feels better because of this decision)
- Making final arrangements
If you see any of the above warning signs, you should:
- Get professional help for the person immediately
- Let them know they are not alone and you care about them
- Offer your support in finding other solutions to their problems