Diagnosis of depression
While you can take an online screening quiz to see if you might have symptoms associated with depression, such quizzes are not reliable for a diagnosis. Depression is usually diagnosed through a clinical interview by a trained mental health professional, such as a psychologist or psychiatrist. Family doctors and general physicians can also make a diagnosis of depression, but they should always refer you to a mental health professional for follow-up care.
Since there are no laboratory or blood tests for depression, a clinical interview is designed to check for the symptoms of depression, determine any alternative diagnoses (such as a medical condition) that might better account for the symptoms, and suggest a course of treatment that will work best for an individual’s needs. Such interviews generally take an hour or an hour and a half to conduct and work best when the person is completely honest with the therapist or doctor.
Treatments for Depression
Once accurately diagnosed, depression is readily treated with a combination of medications and psychotherapy. Most people find relatively quick relief with medications, while psychotherapy can help a person learn to combat some of the issues that help contribute to depression. Depression treatment allows a person to feel better more quickly than on their own. It also often teaches important life skills and techniques to help a person in many different areas of their life, which may help prevent future recurrence of depression.
There are four major classes of antidepressant medications: selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and others. Most Americans are typically prescribed an SSRI antidepressant medication to begin with because they are fairly safe and effective. SSRIs include medications such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), or fluvoxamine (Luvox). Tricyclic antidepressants are older, but are better tolerated in some people. Some tricyclic medications include: imipramine (Tofranil, Janimine), doxepin (Adapin, Sinequan), and clomipramine (Anafranil). MAOIs are rarely prescribed in the U.S. because of their special diet requirements, but include medications such as phenelzine (Nardil) and tranylcypromine (Parnate). Other antidepressants that are also commonly prescribed for depression in the U.S. include venlafaxine (Effexor), nefazodone (Serzone), mirtazapine (Remeron), and buproprion (Wellbutrin).
A doctor chooses a medication based upon his or her previous experience and judgment about what is best suited for the needs of the specific depressed individual. Often when one medication is found to be ineffective, the doctor will discontinue the medication and try another. Most antidepressant medications can take anywhere from 4 to 12 weeks to become fully effective.
Psychotherapy is the second important component of depression treatment. Although there are a wide variety of psychotherapies available for the treatment of depression, the most commonly used types are cognitive-behavioral and interpersonal, or some combination of the two. Cognitive-behavioral therapy emphasizes learning more about how thoughts and feelings interact in most people, how to identify irrational or unproductive thoughts, and how to change those thoughts for the better. Interpersonal therapy focuses on the way a person communicates with others in their lives and seeks to improve those communication patterns through a number of techniques.
Most modern psychotherapies, such as cognitive-behavioral or interpersonal, are time-limited and goal-focused. This typically means therapy takes place once a week for about an hour, for anywhere between 15 and 25 weeks. Psychotherapy requires active, willing participation and work on the part of the individual; it is not a passive exercise where the therapist “does something” to make the person feel better.
Support groups and learning more about depression are two additional important components to many people’s treatment. Online or support groups within your local community are a popular method to find others experiencing similar issues and connect with them without feeling self-conscious or embarrassed about your condition. Learning more about your condition, through online resources or self-help books, gives many people new ideas and more strategies for coping with depression in their lives.
What do I do next about my Depression?
You’ve taken the first step in learning briefly about depression. If you’d like to learn more about depression, please check out our Depression In-Depth content. There you will find dozens of related articles helping you better understand depression and what you can expect in diagnosis, treatment, and ongoing care.
Keep in mind that depression is readily treated when correctly identified and a person receives ongoing care from a professional.
Grohol, J. (2007). An Overview of Depression. Psych Central. Retrieved on September 18, 2014, from http://psychcentral.com/lib/an-overview-of-depression/000892
Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
Published on PsychCentral.com. All rights reserved.