Depression is a complex mental health condition that affects millions of people worldwide. Its diagnosis isn’t as straightforward as a blood test or an X-ray. Instead, it involves a careful evaluation of symptoms, medical history, and sometimes, the use of standardized questionnaires. 

What is Depression

Depression goes beyond occasional sadness or feeling down. It’s a persistent condition that affects how a person feels, thinks, and handles daily activities. Symptoms must last at least two weeks for a diagnosis of depression.

Related: Depression: All You Need To Know

What Are The Risk Factors For Depression

While depression can affect anyone, certain factors increase the likelihood of developing the condition. Here’s a closer look at some of these risk factors:

Genetic Predisposition

Family history plays a significant role in the risk of developing depression. If you have close family members who have been diagnosed with depression or another mood disorder, your risk is higher. This genetic link suggests that some individuals are more susceptible due to their genetic makeup.

Personal or Family History of Mental Health Disorders

Aside from depression, a personal or family history of other mental health disorders, such as anxiety disorders, eating disorders, or post-traumatic stress disorder (PTSD), can increase the risk of developing depression.

Traumatic or Stressful Life Events

Life events such as childhood sexual abuse, a disturbed family environment, the death of a loved one, financial problems, or a divorce can trigger depression in individuals predisposed to the condition. Trauma, especially early in life, significantly increases the risk.

Chronic Illnesses

Living with a chronic illness like diabetes, cancer, or heart disease can lead to depression, partly due to the stress and limitations these conditions can impose on one’s life.

Substance Abuse

Nearly one-third of people with substance abuse problems also suffer from depression. Alcohol and drugs can lead to or exacerbate depression.

Personality Traits

Individuals with certain personality traits, such as low self-esteem, being overly dependent, self-critical, or pessimistic, are more susceptible to depression.

History Of Anxiety

Anxiety and depression often coexist, and the presence of anxiety can serve as a precursor or risk factor for the development of depression

Lack of Social Support

Isolation and lack of social support can increase the risk of developing depression. Strong social networks and supportive relationships are protective factors against many forms of mental illness.

Gender

Women are diagnosed with depression at nearly twice the rate of men. This discrepancy may be due to hormonal factors, social pressures, and a greater willingness among women to seek help for their symptoms.

Age

Adolescents and young adults, as well as the elderly, are at a higher risk for depression, though it can occur at any age. The reasons vary and can include developmental challenges, life transitions, and social isolation, respectively.

What Are The Symptoms Of Depression

Healthcare providers often start by asking about symptoms. Common symptoms of depression include:

• Persistent sadness or low mood
• Loss of interest in activities once enjoyed
• Low energy
• Changes in appetite and weight (either decreased or increased)
• Sleep disturbances (either increased or decreased sleep)
• Feeling lethargic or agitated
• Feelings of worthlessness or excessive guilt
• Difficulty thinking, concentrating, or making decisions
• Thoughts of death or suicide

The presence of a low mood plus four symptoms suggests depression and requires further evaluation.

Depression doesn’t look the same in everyone, especially between men and women. 

Women who are feeling depressed often talk about physical problems like headaches, muscle pain, or stomach issues. They also tend to show more emotional signs, like feeling really stressed or crying easily. 

On the other hand, men dealing with depression are more likely to show it through aggression, anger, using drugs or alcohol, and doing dangerous things.

Related: Will Depression Cause Weight Loss?

How Is Depression Screened

Depression screening is a quick and effective way to check for signs of depression in individuals who may not be aware of their condition. It typically involves a series of questions about one’s mood, behavior, and thoughts.

Doctors, nurses, or mental health professionals might ask you to fill out a questionnaire. One popular tool is the Patient Health Questionnaire (PHQ-9).

PHQ-9

PHQ-9 is a self-administered diagnostic tool for depression. It consists of nine questions that reflect the criteria upon which the diagnosis of depressive disorders is based.

Each question asks respondents to rate the frequency of how they’ve been bothered by certain problems over the last two weeks, including issues like feeling down, trouble sleeping, and changes in appetite. 

Responses are scored on a scale from 0 (not at all) to 3 (nearly every day), with the total score ranging from 0 to 27. 

Higher scores indicate more severe depressive symptoms. 

Based on your answers, healthcare providers can assess whether you might be experiencing depression.

PHQ-2

The PHQ-2 (Patient Health Questionnaire-2) is a simplified version of the PHQ-9, designed to screen for depression in a quick and easy manner. 

It comprises the first two questions of the PHQ-9, which inquire about the frequency of depressed mood and anhedonia (loss of interest or pleasure in activities) over the past two weeks. 

Responses are scored on a scale from 0 (not at all) to 3 (nearly every day), giving a total score ranging from 0 to 6.

A score of 3 or higher on the PHQ-2 suggests the need for a follow-up with the full PHQ-9 to determine if a depressive disorder is present. 

The simplicity and brevity of the PHQ-2 make it a practical choice for use in various settings, including primary care and research, to quickly assess whether depression might be a concern.

Related: Why Depression Increases In Winter?

How is Depression Diagnosed

When screening indicates possible depression, healthcare providers should confirm the diagnosis using DSM-5 criteria.

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) sets specific criteria for diagnosing Major Depressive Disorder (MDD). 

According to these guidelines, an individual must experience at least five symptoms of depression over a two-week period, with at least one of the symptoms being either a depressed mood or loss of interest or pleasure in almost all activities. 

Additionally, these symptoms must cause significant distress or impairment in social, occupational, or other important areas of functioning. 

The condition must not be attributable to the physiological effects of a substance or another medical condition. 

Finally, the occurrence of the major depressive episode must not be better explained by schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders. 

By adhering to these criteria, healthcare professionals ensure a consistent and accurate approach to diagnosing Major Depressive Disorder.

Conclusion

The diagnosis of depression is a multi-step process that involves a careful evaluation of symptoms, medical history, and the use of standardized tools. It’s a critical step in understanding and managing this complex condition. 

If you or someone you know is experiencing symptoms of depression, reaching out to a healthcare provider is an important first step toward getting help. Remember, depression is treatable, and with the right support, recovery is possible.

References

1. BN;, M. D. T. (n.d.). Depression: Screening and diagnosis. American family physician. https://pubmed.ncbi.nlm.nih.gov/30277728/ 
2. McCarron, R. M., Shapiro, B., Rawles, J., & Luo, J. (2021). Depression. Annals of Internal Medicine. https://doi.org/10.7326/aitc202105180