According to the National Institute of Mental Heath, 9.5 percent of Americans suffer from depression. It sometimes goes untreated because people don't recognize its symptoms. In order for depression to be diagnosed, its symptoms must have lasted for more than two weeks and need to be severe enough to interfere with daily life. Tests measuring depression symptoms typically include 10 questions measuring changes in typical everyday behavior. Usually, if someone answers "yes" to half the questions, they are considered to be depressed.
Significance
Clinical depression is a serious medical illness, that can be life threatening. Yet, it is treatable condition, and over 80 percent of all the patients suffering from clinical depression can be helped with medication, psychotherapy or a combination of both. Patients often report starting feeling better within a couple of weeks after treatments begin. The screening tests are important because oftentimes people are not aware that they suffer from depression. Depression is common in all the age groups, races and socioeconomic groups.
Considerations
Doing a simple online test is often the first step a person makes when he tries to find out whether he is suffering from depression or not. It is important to understand, however, that the results of such tests are not enough to diagnose a clinical depression, even if the symptoms have lasted for more than two weeks. When professionals diagnose clinical depression, they take into account much more than this simple test. A patient needs to provide a complete family, medical and mental health history. There are also questions about alcohol and drug use, since substance abuse may cause symptoms that mimic depression. It is also important to rule out other medical conditions that may cause depression-like symptoms. Only a mental health care professional such as psychologist or psychiatrist can determine if someone truly suffers from depression, how severe the depression is and what are the best treatments.
Undiagnosed Depression
Even today, when information about depression is readily available, most people suffering from it never search for help. Many people are under the impression that it is normal to feel depressed. Perhaps they have felt depressed most of their lives and are not even aware of it. Perhaps they are afraid of the stigma of a mental illness. Sometimes people suffering from depression have a physical illness such as cancer, and it is common for both patients and their doctors to focus so much on the physical illness that the depression goes unnoticed.
Misdiagnosed Depression
Paradoxically, while many people suffering from depression do not get diagnosed, depression also tends to be an over-diagnosed condition. It is normal for a person to feel sad after losing a loved one or a job. This can be part of a normal grieving process and has nothing to do with clinical depression. Many drugs, both legal and illegal, can cause depression-like symptoms. Other mental disorders, such as bipolar disorders, can also be misdiagnosed as depression. Moreover, some physical diseases such as diabetes, early menopause and Parkinson's disease, to name only a few, can have symptoms that resemble those seen in patients suffering from depression.
Considerations
Most depression symptom tests seem to have relatively good sensitivity, are easy to use and can be administered in less than 5 minutes. The U.S. Preventive Services Task Force (USPSTF) states that depression screening tests decrease the amount of depression-related suicides. Yet, even in ideal test performance settings, only 24 to 40 percent of patients who screen positive in these tests actually have clinical depression. Thus, many are given a wrong diagnosis. Because of this, the Canadian Task Force on Preventive Health Care (CTFPHC), for example, does not recommend routine screening for depression. False positive findings tend to cause more stress, and financial consequences can be significant. The USPSTF, on the other hand, found that although depression screening tools have many limitations, the benefits substantially outweigh the negatives, and although they do not recommend routine screening either, those who suspect that they might suffer from depression should be tested.
References
- National Institute of Mental Health: The Numbers Count: Mental Illness in America
- Uplift Program: Depression Facts and Stats
- National Institute of Menatl Health: What are the signs and symptoms of depression?
- "Guide to Clinical Health Care"; CTFPHC; 1994
- Counselling Resource: U.S. Preventive Services Task Force
