Diagnosing Depression

Depression can be difficult to diagnose as the depressed person may not wish to admit that they have a problem that needs help. It is estimated that well under half the people who are currently experiencing an episode of depression will seek assistance from medical practitioners.

If you suspect that you may be experiencing an episode of depression, you can complete online check lists which assess your level of psychological distress and calculates whether it is likely you have depression. Such checklists and scales can be found on websites such as www.beyondblue.org.au.

When you make an appointment with your doctor, they will ask questions about your current behaviours, such as have you lost enjoyment or stopped doing activities you previously found enjoyable, have you stopped going out, are you experiencing fatigue or changes to your sleeping patterns, have your eating patterns changed. A doctor may also send you for a battery of blood tests to ensure that there is not an underlying medical condition that may be causing your depression symptoms, such as an underactive thyroid gland.

Finally medical practitioners may use the assistance of depression scales to determine if you are experiencing an episode of depression and whether it is mild, moderate or severe. Depression scales are normally multiple choice questionnaire based requesting that you answer on a series of Likert scale responses (for example this affected me a lot of the time to a little of the time). Some of the more common depression scales include:

Kessler Psychological Distress Scale (K10)

The Kessler Psychological Distress Scale is a self-report symptom checker. The K10 asks questions relating to your feelings of self worth, anxiety, depression and fatigue over the last month. A low score (under 20) suggests that a person is likely to be in good mental health and a high score (30 or over) is an indication of a severe mental disorder. Since it is a self-report scale the K10 is open to under or over exaggeration of symptoms by patients.

Beck Depression Inventory (BDI)

The Beck Depression Inventory was created by Dr Aaron Beck, a psychologist in 1961 and is possibly the most widely used depression severity questionnaire. It asks the respondent to answer questions about depression symptoms in a multiple choice format including questions relating to attitudes (the cognitive aspect of depression symptoms) and physical symptoms. Amongst other items, the Beck Depression Inventory covers items including the patient’s mood, feelings of failure, pessimisim, self-hate, negative self talk, if your symptoms are affecting your work or other social withdrawal. As a self-report scale, the Beck Depression Inventory can be subject to incorrect ratings with the patient either over or under exaggerating their symptoms.

Hamilton Rating Scale for Depression (HRSD or HAM-D)

The Hamilton Rating Scale for Depression is a clinician led scale based on interviews and observations. It is used where a diagnosis of depression has already been made, in order to assess the severity of the depression episode. It is a 21 question multiple choice scale and includes the areas of depressed mood, suicide ideation, guilt, agitation, anxiety, insomnia, work and interests and weight loss. The clinician rates the patient’s symptoms on a grade scale from absent to severe (for symptoms like depressed mood) and from absent to clearly present (for weight loss symptoms). The success of the Hamilton Rating Scale for Depression in assessing the severity of a patient’s depression comes from the skill of the clinician undertaking the interview and observation process.

Geriatric Depression Scale (GAD)

The Geriatric Depression Scale is a simplified self-report questionnaire in either long form (30 questions) or short form (15 questions) for use with the elderly population. It asks the patient to respond yes or no to a series of questions in relation to their feelings in the last week. The short form of the Geriatric Depression Scale can be used with physically ill or mild to moderate dementia patients as it is simple and quick to administer. This scale covers questions including life satisfaction, interests, feelings of helplessness, worthlessness and fear and the current energy levels of the patient. The Geriatric Depression Scale does not rate the severity of the depression, it is used to indicate whether a patient may be experiencing depression and may require further assessment and treatment. It is similar to the Kessler Psychological Distress Scale mentioned above.

Depression is a serious medical condition for which treatment is available. If you or someone you know experiences any of the following symptoms for more than 2 weeks:

* depressed mood;
* loss of interest in most of your normal activities;
* weight loss or gain;
* sleep problems;
* lack of energy and tiredness;
* feelings of worthlessness or guilt;
* problems with concentration or decision making;
* thoughts of death

please seek treatment from a medical practitioner. Help is out there and the use of depression scales enables medical practitioners to assist you to gain the best treatment for your condition and regain your life!