Depression Screening: Signs, What a Visit Involves and Where to Start

What it involves

MedlinePlus describes depression as more than being sad or irritable for a few days. It calls it a serious mood disorder that can affect how you think, feel, and manage everyday life, including sleeping, eating, and working, and it says getting help at the earliest sign of a problem can help manage symptoms.

Who this is for

• Patients who have felt down, empty, or numb most days for two weeks or longer
• Patients who have lost interest in work, hobbies, or time with family
• Patients with unexplained tiredness, aches, or sleep changes who want to rule out mood as a cause
• Family members who see a loved one withdrawing and want to know how to start the conversation

What to expect

• Questions about your mood, sleep, appetite, energy, and how long things have felt this way
• A conversation about your mood, since national guidelines list depression screening for adults as part of preventive care
• A physical exam and, when it makes sense, blood work to rule out medical causes such as a thyroid problem
• A plan that may include counseling, medicine, or a referral to a mental health provider

What depression can look like

MedlinePlus says depression does not look the same in everyone and does not always appear as sadness. The symptoms it lists include:

• Feeling sad or empty, or hopeless, irritable, anxious, or guilty
• Losing interest in favorite activities
• Overeating or not wanting to eat, and sleeping too much or too little
• Feeling very tired, or having aches, pains, headaches, cramps, or digestive problems
• Isolating from family and friends, or using more alcohol or drugs

Different people, different signs

MedlinePlus notes that children may seem more irritable than sad, teens may act out or sleep excessively, and older adults may show symptoms that are less obvious. It adds that men often appear angry or irritable rather than sad. Some medicines and medical conditions can cause symptoms that look like depression, and chronic conditions can make depression worse, which is one reason this conversation fits in primary care alongside the fatigue guide and sleep concerns.

How it is diagnosed

MedlinePlus says a provider may use a medical history, a physical exam, and a mental health evaluation. To be diagnosed, symptoms must occur most of the day, nearly every day, for at least two weeks, and one of them must be a depressed mood or a loss of interest in most activities. Medical tests may be done to rule out other causes, and the thyroid blood tests guide explains one of the common ones.

Treatment options

MedlinePlus says most treatment includes medicines, psychotherapy, or both. Antidepressants may help control symptoms, but it can take time to find the right one, and it warns not to stop a medicine without talking to your provider. Psychotherapy, or talk therapy, helps people recognize and change troubling emotions, thoughts, and behaviors. Light therapy has been shown to be effective for seasonal affective disorder, and other treatments are considered when depression is severe. Counseling is typically arranged with a mental health provider.

Habits that support mental health

MedlinePlus says most cases of depression cannot be prevented, but healthy changes can have long-term benefits for mental health. It lists regular exercise, a consistent sleep schedule, and controlling stress. Poor sleep and mood affect each other, and the insomnia guide covers common causes of trouble sleeping.

If you are in crisis

MedlinePlus says that if you or someone you know has thoughts of hurting themselves or attempting suicide, get help right away, and to dial 911 in an emergency. You can also call or text 988, the Suicide and Crisis Lifeline, at any hour. A routine office visit is not the right place for an emergency, and the urgent care or ER guide explains how to choose where to go.

Sources

• MedlinePlus — Depression
• MedlinePlus — Mental Health