Diagnosing Major Depression

Diagnosing Major Depression

Joseph A. Kwentus, MD Precise Research Centers Psychiatrist, Principal Investigator

Major Depression (also known as Clinical Depression or Major Depressive Disorder) is a mental disorder that is not simply or quickly diagnosed. Depressive behavior can come from a wide variety of factors that do not necessarily indicate that an individual has Clinical Depression. There are also a lot of mood disorders that may appear similar to Major Depression before being diagnosed, such as bipolar disorder or dysthymia, that have distinguishing characteristics that only a psychiatrist can determine. Therefore, psychiatrists perform several tests and evaluations on the inquiring individual, as well as obtaining all other types of necessary information, such as the individual’s symptoms, family history, current medications, social setting, etc to properly diagnose an individual for Major Depression.

Depression Symptoms

Clinical Depression is a mental disorder that can enormously affect the way you think and feel, your eating habits, and you mood and behavior. It is important to distinguish Major Depression from occasional feelings of the “blues” because it is a mental illness that may lots of time and attention to overcome. When evaluating an individual for Major Depressive Disorder, a psychiatrist looks for a wide range of symptoms. The most determining symptoms of Major Depression are low self-esteem and loss of pleasure in daily activities, especially those that the individual once enjoyed before. Other symptoms usually include a sense of guilt, worthlessness, hopeless and helplessness, and self-hatred. More severe symptoms include delusions or hallucinations, poor memory and concentration, isolation from social activities, decreased sex drive, and thoughts of death or suicide.

Uncovering these symptoms and other factors indicating that an individual has Major Depression can be very difficult, and therefore, the diagnosis process usually begins by ruling-out the physical reasons that could be causing the individual’s depression. At times, an individual’s medications or other factors are the culprit behind a person’s depressive sickness. To rule-out the physical causes, examinations such as blood tests, CT scans, and others may be carried out. Once these have been taken care of, the next step is for the psychiatrist to evaluate the individual for affective, behavioral, cognitive, and somatic symptoms that could be related to Major Depression. Lastly, an interview will take place between the psychiatrist and the individual to discuss the individual’s symptoms and the origin or frequency of these symptoms, family history, and other information that the psychiatrist feels necessary to diagnose the individual for a depressive disorder.

Diagnosing Mental Disorders

For the evaluation process, a system has been developed for a psychiatrist to use to properly diagnose the mental disorders such as Major Depressive Disorder. This system is called the Diagnostic and Statistical Manual for Mental Disorders or the DSM multiaxial system. Its purpose is to organize a psychiatric diagnosis into five different dimensions, named Axis 1 through Axis 5, and based on these results, there is a corresponding reference of what type of disorder the individual has. The bullet points below indicate the different dimensions that are considered why the DSM multiaxial system.

1. Axis 1: Clinical disorders including major mental, learning, or substance use disorders

2. Axis 2: Intellectual disabilities and personality disorders

3. Axis 3: Acute medical and physical conditions

4. Axis 4: Psychosocial and environmental conditions

5. Axis 5: Global Assessment of Functioning, or if under 18, Children’s Global Assessment Scale