Depression is a mental illness that can be debilitating without treatment. The Centers for Disease Control found one in 10 U.S. adults suffer from depression. Those most affected include women, people 45-64, those currently unemployed or unable to work, and people without health insurance coverage, though depression can affect people from all walks of life. Depression is not just feeling a little blue.
“We all feel down if we get a bad grade or have a break-up; that’s normal,” says Gabriela Cora, MD, MBA, a Miami-based psychiatrist. “It may not be normal if I just broke off an engagement with my boyfriend and I want to kill myself.” Most people either seek treatment on their own or are referred by their family doctor to a psychiatrist -- a doctor who specializes in mental health.
When you see your doctor for depression, you will be asked about your symptoms. Specifically, your doctor will want to know two things:
- The severity of your depression
- How long you’ve been depressed
Cora says that depression severity is tied to your level of functioning. In a mild depression, someone may feel low but still go to work or school, participate in activities but not with the level of interest or zest they had before. They may lack energy and have some difficulty with daily tasks. “I would advocate people to be as truthful as possible when speaking with the doctor so they can assess how severe it is,” says Cora.
If you’re experiencing a moderate depression, you may skip work, or go but have trouble finishing projects or concentrating, feel low most of the time, and not find pleasure in any of the activities you previously did.
If you can’t get out of bed or function well, and your cognition (thinking, memory, attention and decision making) has slowed and you’re thinking about death or dying, you are having a severe episode of depression, Cora says.
On your first visit, a psychiatrist will do a comprehensive psychological evaluation. This will include:
- A discussion of your symptoms
- An assessment of your current mental status
- A discussion of your general concerns
- A psychological, medical, social, and family history
- Questions about your education and relationship status
Your doctor may ask:
- If you have had a history of drug abuse or prior depression.
- If you are currently taking medication.
- If you’ve experienced symptoms of mania or hypomania, which if present, suggests bipolar disorder. Bipolar disorder is a condition in which people experience periods of mania and depression.
- If your depression has seasonality. This means that depression symptoms occur almost exclusively during certain times of the year. If so, you may have Seasonal Affective Disorder (SAD), a type of depression that occurs at certain times of the year -- typically in the winter -- and has been linked to reduced sunlight exposure in the colder seasons.
- If the onset of depression symptoms coincides with a medical illness like heart disease or cancer, or emotional triggers like a divorce or death of a loved one.
At the end of the session, the psychiatrist will provide a diagnosis. “Depending on symptom severity and the specific subtype of depression, I make a recommendation to the patient as to what the appropriate treatment approach should be,” says Angelos Halaris, MD, professor of Psychiatry and medical director of the department of psychiatry at Loyola University Medical Center.