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An accurate diagnosis of depression is made using combinations of the following methods:

Face-to-face: In psychiatry, the key part of a medical diagnosis is the clinical one-on-one interview. It helps the psychiatrist understand what is happening in a person’s life. It also helps define specific stressors or problems, and allows the physician to ask the person how they are feeling and what has changed to cause the depressed mood.

Rating scales: Rating scales such as the Geriatric Depression Scale (there are others) are assessment tools that work based on answers to simple questions. The score derived from the client’s answers helps determine if they are depressed, to what level and whether they need further evaluation. This type of scale is helpful for screening depression, measuring the severity and tracking improvement over time, but it does not replace a thorough examination by a qualified professional for diagnosis.

History: Collateral or corroborating history gathered through interviews with family members, or others who know the client well are also very important for assessing a client’s mental health, especially in geriatrics. These interviews provide an alternate perspective that is crucial.

Myth

I’m feeling depressed, but I should be able to get over it myself. I don’t need help.

Fact

Early diagnosis and treatment are key to ensuring positive results and relief from depression.

Process of elimination: Identifying and ruling out reversible medical problems:

  • Ruling out medications that cause or mimic depression
    • Has the client been prescribed new medications?
  • Identifying substances, such as alcohol, that act as a depressant
    • What is their average intake?
    • Do they have a history of substance abuse?
  • Taking blood and doing routine blood work can rule out medical conditions that cause depressive symptoms and can be treated
    • Low blood/hemoglobin (anemia).
    • Vitamin B12 deficiency.
    • Low levels of thyroid hormone.
  • Brain scan, CT scan or MRIs show specific details of what is going on in the brain
    • This option is not standard - it is up to the judgment of the clinician and would be used depending on how the person is presenting with the depression, their history and other factors.