What tests to take for depression. Depression
During the first visit to diagnose depression, the doctor asks the patient questions about his mood and thoughts. He may also ask you to complete some simple tests to screen for symptoms of depression.
If, after the initial interview, the doctor suspects depression, he will conduct a full range of laboratory tests and psychological tests. This allows you to exclude other diseases with similar symptoms, confirm the diagnosis of depression and identify complications caused by the disease.
Typically, diagnosis includes the following activities.
Physical condition check
Measurement of height and weight, measurement of blood pressure and temperature, listening to the heart and lungs, palpation of the abdominal cavity.
Laboratory tests
Complete blood count, blood test for alcohol and drugs, blood test for thyroid hormones.
Psychological research
Consists of a conversation with a psychotherapist. The doctor asks the patient about his thoughts, feelings, behavior, finds out about the symptoms of the disease: when they appeared, how acute they are, how they affect everyday life, whether you have experienced episodes of depression in the past. If the patient has thoughts of suicide, the doctor discusses this issue in detail with the patient.
Diagnostic criteria for depression
The symptoms of major depression are similar to those of some other illnesses, so making a diagnosis requires careful evaluation. To distinguish major depression from other diseases, the doctor conducts a detailed examination of the patient. When making a diagnosis, the doctor must exclude the following diseases that have symptoms similar to depression.
Adjustment disorder
Adaptation disorder is observed during the period of adaptation to a significant change in social status (loss of loved ones or long-term separation from them, refugee status) or to a stressful life event (including a serious physical illness). This mental condition affects the thoughts, feelings and behavior of the patient.
Bipolar disorder
This type of depression is characterized by mood swings from euphoria to depression. Bipolar disorder is often confused with major depression, although it is the correct diagnosis in this case that determines the outcome of treatment.
Cyclothymia
Cyclothymia refers to mood swings that do not reach manic-depressive psychosis (bipolar disorder).
Postpartum depression
This type of depression occurs in new mothers, usually a month after the birth of a child.
Psychotic depression
This is severe depression, accompanied by psychosis, which is expressed by delusions and hallucinations.
Schizoaffective disorder
Schizoaffective disorder is a disorder that involves both schizophrenia and mood disorders.
Seasonal depression
This type of depression is associated with the changing seasons and lack of sunlight.
Major depressive disorder differs from these diseases in its symptoms and severity. For a correct diagnosis, it is necessary that the symptoms meet the following diagnostic criteria:
- symptoms have been present daily for two or more weeks;
- depressed mood;
- loss of interest in daily activities;
- significant unplanned weight gain or loss;
- sleep problems: sleeping too long or too short, taking a long time to fall asleep;
- feeling of restlessness, anxiety;
- lethargy, slowness;
- fatigue, lack of energy;
- loss of self-esteem, the appearance of guilt;
- problems with concentration and decision making;
- thoughts of death and/or suicide;
- the symptoms cause distress to the patient and affect daily life.
The term “depression” has become so familiar in the modern world that we are ready to characterize any internal tension as depression. But is there a medical diagnosis for this mental disorder? How do you know if you are suffering from depression?
In most cases, doctors make a diagnosis from the patient’s words, which can hardly be called objective symptoms of the disease, and, as a rule, they are inaccurate and approximate. So it turns out that the diagnostic method is the stories of patients. But if a cold or other physiological disease can be confirmed by laboratory tests, then with depression everything is more complicated... it was until recently. Since there are more than a dozen types of depression, the number of tests to identify them was enormous.
However, now American scientists have developed a special biochemical test that will help determine the symptoms of depression with a high percentage of accuracy. This blood test, aimed at identifying nine substances, changes in the level of which indicate the presence or absence of a depressive state in patients.
More than a hundred people took part in the experiment (some with depression, others healthy). The results of the study are impressive: the test accuracy was 90%!
What is taken into account in a blood test for depression?
Epidermal growth factor,
Alpha 1 antitrypsin,
Brain-derived neurotrophic factor
Cortisol and prolactin,
Resistin and myeloperoxidase,
Soluble tumor necrosis factor receptor 2,
Apolipoprotein C3.
It has been established that these substances respond to inflammation, stress and other physiological processes of the body.
Previously, laboratory methods for determining depression have been attempted more than once. Now such a method has appeared. Employees at Massachusetts General Hospital have created a biochemical test that can use nine blood parameters to determine whether a patient is depressed.
Early attempts to find a diagnostic method failed because they were based on one sign. However, one sign could not provide reliable information. Then scientists began to analyze the disease using nine blood parameters, which led to a true diagnosis.
Thus, now the presence of depression can tell blood test, which will be more reliable than the patient’s usual description of his feelings and moods.
If you are seeing your doctor about depression, we will provide you with a list of tests your doctor will order. But do not forget that not all tests taken are designed to determine the presence of depression. Most are done not to detect depression, but to rule out the possibility of a more serious physical illness that may cause symptoms similar to depression.
First of all, the doctor will conduct a general examination and prescribe tests that will determine whether your condition is caused by diseases such as decreased thyroid function or cancer. If your depressive symptoms are caused by a serious physical illness, treating the illness will reduce the symptoms of depression.
What does a doctor pay attention to during a general examination when diagnosing depression?
During the general examination, the doctor will pay special attention to the nervous and hormonal systems. He will try to identify all physical ailments related to depression. For example, hypothyroidism, an underactive thyroid gland, is the most common physical ailment associated with symptoms of depression. Other types of hormonal disorders are hyperthyroidism - an overactive thyroid gland - and Cushing's syndrome - a disorder of the adrenal gland.
Many diseases or injuries to the central nervous system can also cause symptoms of depression. For example, depression is associated with any of the following conditions:
Various types of cancer (such as pancreatic, prostate, or breast)
Tumor of the central nervous system
Head injury
Multiple sclerosis
Corticosteroid hormone medications, such as prednisone, taken for conditions such as rheumatoid arthritis or asthma, are also associated with depression. But drugs based on illegal steroid hormones or amphetamines, as well as appetite suppressants, in turn cause depression when they are stopped.
What laboratory tests will your doctor perform when diagnosing depression?
After doing a general examination of the body and analyzing the information you provide, the doctor will be able to tell whether you have depression or not. But, in order to exclude the presence of a serious physical illness, the doctor may order additional tests. He or she will likely order a blood test to see if you have an illness that may be causing your symptoms of depression. Based on the results of this test, your doctor will be able to determine whether you are anemic and will check your thyroid function and calcium levels in your body.
Are there additional laboratory tests that a doctor may order before making a diagnosis?
Yes, the doctor may prescribe other standard tests in the process of examining the general condition of the body. For example, a blood test to determine electrolyte levels, liver and kidney health. Since the liver and kidneys are responsible for removing medications from the body, disruption of their function can lead to the accumulation of medications taken, and as a result, depression.
Additional laboratory tests include:
CT scan or magnetic resonance imaging of the brain to rule out the possibility of a serious condition such as a brain tumor
An electrocardiogram (ECG) to detect arrhythmia or heart block
Electroencephalogram (EEG), designed to determine the level of electrical activity in the brain
Are there special types of tests to diagnose depression?
After asking about your mood and how it affects your daily life, your doctor will ask you specific questions used when diagnosing depression. It is important to remember that all questionnaires that the doctor uses to make a diagnosis are just tools for analyzing your condition. The information obtained from these questionnaires will give your doctor a deeper understanding of your mood. He will definitely use these results when making an accurate diagnosis.
One example of such tests is a questionnaire consisting of two questions:
1. Have you been bothered by feelings of depression, depression or helplessness over the past month?
2. Over the past month, have you experienced a feeling of indifference to your once favorite activities?
The doctor’s next actions will depend on how you answer the questions. He may ask you additional questions to confirm the diagnosis. Or, if the answers indicate that you are not depressed, your doctor will do more tests to find the cause of your depressive symptoms.
In addition, the doctor may use the following types of tests:
The Beck Depression Rating Scale is a test consisting of 21 questions, the answers to which will enable the doctor to determine the degree of complexity of depressive symptoms.
The Zung Self-Rating Depression Scale is a short test that measures the severity of depression from mild to severe.
The Center for Epidemiological Studies Depression Scale is a test that allows the patient to evaluate his feelings, behavior and worldview in terms of the past week.
While taking these tests, you may be embarrassed to answer the questions honestly. In the tests you will find questions about depression and mood, depression and learning ability, physical manifestations of depression, such as decreased vitality, sleep problems or sexual dysfunction. Despite this, try to answer the questions as honestly as possible. This will help the doctor make an accurate diagnosis and prescribe the most effective treatment.
What to do if your doctor diagnoses you with depression?
Remember, depression is treatable. Therefore, getting diagnosed with depression will help you get on the road to recovery and leave behind feelings of helplessness, hopelessness, and worthlessness.
If you have been diagnosed with depression, follow all your doctor's advice to improve your condition. It is very important to take the prescribed medications. You should also make every effort to change your lifestyle and attend psychotherapy sessions. Millions of people from all over the world suffer needlessly from this disease simply because they do not receive adequate professional help, which begins with a diagnosis.
Scientists continue to study such a common one. This is a condition that affects a person’s behavior, worldview and sense of self. Since some representatives cross the threshold from a normal depressive state to a severe form of its development, serious treatment should be applied here.
Clinical depression is a diagnosis made by a doctor. A healthy person can also be in a depressed mood, feel a loss of strength and look at the world pessimistically. But what distinguishes him from the patient is that this condition is temporary. If a healthy person falls into a depressed state for only a few days, then the patient practically lives in a depressed mood. The longer the depressed mood lasts, the faster the clinical disorder develops.
How often is this disorder diagnosed? Readers of the online magazine site may be interested in this question, which helps to start helping loved ones in advance who, for one reason or another, have become victims of a depressive state:
1. Muscular inhibition, manifested in a passive lifestyle.
2., which affects human passivity.
3. Lack of joy in life, accompanied by constant thoughts about losses and failures in the past.
4. Negative perception of the world, often distorted due to unpleasant memories.
Scientists have conducted studies that have shown that depression has a psychosomatic effect on the body of its owner. In addition to mental illness, a person begins to develop painful symptoms that worsen his health. Thus, blood tests were carried out on some patients with depression, which showed biomarkers of an inflammatory nature. Whether they are a consequence of an emotional mood or a person has lost heart due to inflammatory processes in the body, this will still have to be investigated. But tests were carried out, during which, along with antidepressant drugs, anti-inflammatory medications were given. What results were obtained? Medicines have had a positive effect on people with severe forms of mental illness.
Just like the body has a direct impact on how a person develops and feels on a mental level. There are many mental diseases that originate in the occurrence of pathologies in the functioning of the body. If the body is sick, then human thinking changes. If the eyes and brain incorrectly perceive information coming from the outside, then the person begins to hallucinate. It also happens in the opposite direction: if an individual is mentally ill, then there is a risk of developing various psychosomatic diseases.
Depression is associated with inflammatory processes that occur in the body. What is primary remains to be seen. But the practice of psychiatrists will include a blood test, which should also take into account the physiological state of the patient, which should not be ignored. In this case, complex treatment will be prescribed, which includes not only psychological therapy to get rid of a depressed state, but also medicinal methods that eliminate the symptoms accompanying this disease. This will eliminate the possibility of depressive disorder due to body dysfunction.
Attempts to find an objective diagnostic tool for depressive disorder have been going on for several decades, but until recently they remained fruitless. Psychiatrists still make the diagnosis of depression based on the patient’s stories, various questionnaires and their own experience and intuition, that is, essentially, using methods not even of the past, but of the century before last. Moreover, the main symptoms of depression, such as emotional depression, fatigue or sleep and appetite disturbances, are non-specific, that is, they can be caused by a number of different diseases, and from time to time they can also appear in healthy people. This, of course, also complicates diagnosis.
It is not surprising that as a result, patients begin treatment with a great delay, which in the USA, for example, averages from 2 to 40 months - and this does not take into account those who live like this, and often even die prematurely, not realizing that It's not like that with him.
Perhaps now the situation will change radically. Experts from the Feinberg School of Medicine at Northwestern University in Chicago published an article in the journal Translational Psychiatry about their development*, which will hopefully revolutionize the diagnosis of depression. The patient will only need to take a blood test, which will reveal the levels of 9 RNA markers associated with depressive disorder (RNA molecules play the role of “messengers” in a living organism; they “decipher” the DNA genetic code and carry out its “instructions”).
Moreover, the level of some of these RNA markers can even predict whether a patient will benefit from cognitive behavioral therapy (this approach assumes that a person’s feelings and behavior are determined not by the situation in which he finds himself, but by his perception of this situation).
According to co-leader of the work, Professor Eva Redei, who developed the test, the analysis will bring the diagnosis of mental disorders into line with 21st century standards. “Now we know that medications help, but not everyone, and psychotherapy also helps, but not everyone either. We also know that combining one with the other is more effective than using drugs or psychotherapy separately, but by combining these two methods mechanically, we are shooting short. The ability to do a blood test will allow treatment to be prescribed more accurately, taking into account the individual characteristics of patients,” says another co-leader, Professor David Mohr.
The study involved 32 people aged 21 to 79 years, who were diagnosed with the disease based on the results of a clinical conversation, and all of them had previously been involved in another study that compared the effectiveness of face-to-face and telephone sessions of cognitive behavioral therapy. In addition, some took antidepressants for a long time, but the effectiveness of such treatment was low. The control group consisted of another 32 people who did not suffer from depression.
Before the start of psychotherapeutic sessions, all participants had their levels of RNA markers measured and the measurements were repeated at the end of the 18-week course. At the start, the levels of markers in patients with depression were significantly different from those in the control group. At the finish line, the levels of 3 of the 9 RNA markers changed in some of them, while in others they did not. Moreover, it was those for whom they changed who responded well to psychotherapy and showed a noticeable improvement, but for those whose analyzes remained the same as they were, psychotherapy did not help. It is these three markers, emphasizes Eva Redei, that may also indicate a physiological predisposition to depression, even if the patient is not currently experiencing a depressive episode.
Of course, this is just the first sign, and the results still need to be verified and refined with the involvement of larger groups of patients, so blood testing for depression will not become routine practice tomorrow. But if everything goes smoothly, it will certainly become: the authors intend to continue their work and, in particular, try to invent a test that would distinguish depression from the often similar bipolar affective disorder.
* E. Redei, B. Andrus, M. Kwasny, J. Seok, X. Cai, J. Ho, D. Mohr “Blood transcriptomic biomarkers in adult primary care patients with major depressive disorder undergoing cognitive behavioral therapy.” Translational Psychiatry, September 2014.
