Feeling low every now and again is common, but experiencing depression symptoms throughout the day and every day for more than two weeks could be clinical depression, and help should be sought from a doctor.
How does a doctor make a depression diagnosis?
There are no laboratory tests for depression. Instead a doctor will make a diagnosis based on what a person tells them about their symptoms and how they are feeling.
The doctor will want to know about daily moods, behaviours, and lifestyle habits.
What does the doctor look for to make a depression diagnosis?
A doctor can rule out other conditions that may cause depression with a physical examination, personal interview, and lab tests. The doctor will also conduct a complete diagnostic evaluation, discussing any family history of depression. Your doctor will evaluate your symptoms, including how long you've had them, when they started, and how they were treated. Your doctor will ask questions about the way you feel, including whether you have any symptoms of depression such as the following:
- Persistently sad, anxious, or empty moods
- Loss of pleasure in usual activities (anhedonia)
- Feelings of helplessness, guilt, or worthlessness
- Crying, hopelessness, or persistent pessimism
- Fatigue or decreased energy
- Loss of memory, concentration, or decision-making capability
- Restlessness, irritability
- Sleep disturbances
- Change in appetite or weight
- Physical symptoms that do not have a diagnosable physical cause and do not respond to treatment - especially pain and gastrointestinal complaints
- Thoughts of suicide or death, or suicide attempts
- Poor self-image or self-esteem - as illustrated, for example, by verbal self-reproach
How can depression symptoms lead to a depression diagnosis?
To be diagnosed with clinical depression, you usually will exhibit one of the first two and a number of the other symptoms listed above. Such disturbances must be present nearly daily for at least two weeks.
Depression symptoms can last for months or years. They can cause significant personality changes and changes in work habits, making it difficult for others to have empathy for you. Some symptoms are so disabling that they interfere significantly with your ability to function. In very severe cases, people with depression may be unable to eat or even to get out of bed.
Symptomatic episodes may occur only once in a lifetime or may be recurrent, chronic, or long-standing. In some cases, they seem to last forever. Occasionally, symptoms appear to be precipitated by life crises or other illnesses. At other times, they occur at random.
Clinical depression commonly occurs along with other medical conditions such as heart disease or cancer, and worsens the prognosis for these diseases.
Are there physical signs of depression?
There are no inevitable physical signs of depression, though some manifestations may be seen quite often. Signs of depression may include the following:
- Appearance of preoccupation
- Lack of eye contact
- Memory loss, poor concentration, and poor abstract reasoning
- Pacing, hand wringing, and pulling on hair
- Psychomotor retardation or agitation, such as slowed speech, sighs, and long pauses
- Self-deprecatory manner, or belligerence and defiance (especially in adolescents)
- Slowed body movements, even to the extent of being motionlessness or catatonia
- Tearfulness or sad countenance