How Depression is Diagnosed and Treated

Depression is a devastating type of mental illness that affects millions of people. It makes it difficult to think, to focus, to function, to meet responsibilities and to enjoy life. It is essential to understand and be aware of the signs and symptoms of this illness in order to know when to seek a professional assessment and diagnosis. With an accurate diagnosis, depression can be treated and managed, restoring function and enjoyment to a person’s lie.

What is Depression?

Depression is also called major depression or major depressive disorder. It is a mental illness classified as a mood disorder, because it causes a persistently low and depressed mood. The symptoms of depression are much more than a typical, mild period of sadness or feeling down. Unlike these perfectly normal low moods, depression will not get better on its own. It requires treatment to manage this chronic, lifelong condition.

There are a few different types of depression,1 some of which are related to a period in one’s life. For instance, postpartum depression occurs when a woman who is pregnant or has just given birth experiences an intense episode of sadness, anxiety, guilt and hopelessness. Other types of depression cause severe symptoms that can be upsetting and even dangerous, like psychotic depression. This type triggers delusions or hallucinations, often related to guilt and depression. Seasonal affective disorder is winter depression, and persistent depressive disorder is a high-functioning depression that persists for two years or longer.

Facts about Major Depression

Depression is one of the most common types of mental illness that affects people in the U.S. and worldwide.

  • The prevalence of depression in U.S. adults in 2016 was 6.7 percent, which amounts to 16.2 million people who struggled with depression that year.2
  • Prevalence was higher in women than in men and highest among those aged 18 to 25.
  • Of the 16.2 million adults with depression in 2016, 10.3 million were severely impaired during at least one depressive episode.
  • About 37 percent of U.S. adults who have depression do not receive treatment.
  • The prevalence of depression in teens, between the ages of 12 and 17, was 12.8 percent, or 3.1 million individuals, in 2016.
  • Only 40 percent of teens with depression get treatment.
  • Around the world, over 300 million people struggle with depression. It is the leading cause of disability in the world.3

How Mental Health Professionals Diagnose Depression

Depression can be successfully and effectively treated, but first it needs to be diagnosed. Mental health professionals, and sometimes primary care physicians, make these diagnoses by following the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The diagnostic procedure may include a physical and medical exam, including a blood test, to rule out other conditions, a psychiatric evaluation, questionnaires and observations. To make a diagnosis of major depression, a health care worker must observe at least five of the criteria in the DSM-5 guidelines:4

  • A depressed or sad mood on most days for at least two weeks
  • Loss of interest in activities
  • Significant and unintentional weight loss or weight gain
  • Insomnia or oversleeping
  • Agitation and restlessness or slowed affect
  • Fatigue
  • Feelings of worthless, guilt or shame
  • Difficulty making decisions or concentrating
  • Thoughts of death or suicide

Managing Depression with Therapy

Therapy is an important part of treatment for depression. Cognitive behavioral therapy and other types of therapy can help a person with depression make positive changes to improve function and mood. Ways in which therapy can help include learning to manage low moods and difficult situations, using healthy strategies to cope with stress, and developing and maintaining positive relationships with other people. Therapy can also help a person learn to identify triggers that make depression worse and find ways to cope or avoid them.

Group, couples or family therapy can also be a useful part of depression treatment. Working with loved ones helps provide them with education about depression and strategies for better supporting a family member in a depressed mood. Group therapy and support helps those with depression gain strength and support each other, while being able to share feelings and experiences in a safe environment.

The Role of Antidepressants

Medication alone is not the best strategy for treating depression, but antidepressants do play an important role in managing mood and symptoms. Most physicians begin by prescribing a selective serotonin reuptake inhibitor, or SSRI, a category of medications that includes Prozac, Zoloft, Paxil and Celexa.5 It can take as long as six weeks on an antidepressant to find out if it will work and if the side effects are tolerable. Many people need to try two or three before they find the drug that works best for them.

When SSRIs don’t work, a doctor may try other types of antidepressants, but these are generally considered the most effective with the fewest side effects. Antidepressants, when they work well, help improve mood, reduce fatigue, restore interest in other activities and stabilize eating and sleeping habits. Potential side effects include nausea, weight gain, drowsiness, sexual dysfunction, dry mouth, constipation, dizziness, agitation and blurred vision.6

Rehab for Depression

For many people with depression, regular or ongoing therapy on an outpatient basis combined with medication is adequate for improving mood and function. However, some people struggle to manage the condition or experience severe episodes that require more intensive treatment. In these cases, rehab or residential care can be useful. This allows a person to spend an extended amount of time focusing on therapy and getting accustomed to antidepressants in a safe, supervised setting. In extreme cases, short-term hospitalization may be required to stabilize a person and keep them safe.

Depression is a real and very serious mental illness. It can be managed, and the outlook is largely positive for people who are diagnosed and treated with therapy, medications and lifestyle changes. The most important factor is recognizing the signs of depression and reaching out for help as a result. Without getting a diagnosis or professional treatment, depression will not resolve.