My fourth principle for recovery from depression says, “With the right help, you can live a happy and fulfilling life.”
Getting the right help first requires proper diagnosis. If you think you are depressed, your doctor can help with screening to see if you need therapy.
***Disclaimer: I am not a doctor or licensed therapist. Any advice I’m offering is based on research and personal experience. Unlike WebMD articles, it has not been vetted by professionals.***
I think the way I can be most helpful is not as a professional but as a bridge between the professional and layperson. I am a layperson myself but with personal experience of clinical depression and treatment for it. If you think my experience might inform you, keep reading.
Should I Get Tested?
The American Psychiatric Association (APA) has a list of symptoms of major depression. You could look at that, but these two questions might make it simpler:
- During the past month, have you been bothered by feeling down, depressed, or hopeless?
- During the past month, have you been bothered by loss of interest or pleasure in doing things?
If you answer “yes” or “some” to one or both of these, it’s a good idea to talk to your doctor about being tested for depression. Information about how they test is available online. However, I don’t think you should look into testing beforehand more than this. If your doctor wants to ask more questions, I think it’s best not to prepare for it ahead of time. Just answer the questions honestly and leave the diagnosis to the professionals.
Is It Depression or Something Else?
First, however, your doctor will probably want to eliminate any physical causes of your symptoms. There are a number of conditions with symptoms similar to depression, including
- Hypo- or hyper-active thyroid. If your thyroid gland is too active not active enough
- Nutritional deficiencies, especially vitamin-D or calcium
- Certain types of cancer or tumors
- Hormone imbalances
- Cushing’s disease (a disorder of the adrenal gland)
- Head trauma
- Multiple Sclerosis (MS)
- Certain medications, e.g., corticosteroids
- Withdrawal from certain medications (for example, steroids, amphetamines, OTC appetite suppressants, or anti-depressant medications)
Some of these you probably already know if they apply to you. Others you will probably have to be tested for. Consult your doctor about which tests are appropriate for you. The most common physical causes of depression have to do with the brain and nervous system, thyroid and endocrine system, or sometimes a nutritional deficiency such as Vitamin-D or calcium.
And here’s a couple of tidbits I learned from personal experience. Many types of depression are related to a serotonin deficiency. So is Irritable Bowel Syndrome. So if you have IBS, chances are you will be depressed too. Also, if you recently had heart surgery, many post-op patients experience depression.
If your depression is not related to any physical causes like the ones listed above, the doctor should screen you for depression. This will involve answering some questions that may make you uncomfortable. But as usual, you should answer your doctor honestly if you want an accurate diagnosis. Doctor-patient confidentiality is there for a reason.
There are several testing options your doctor can choose from. I’m not going to explain them because, unlike when you were in school, I think it’s best to go into these tests without “preparing” for them. Your doctor needs honest answers, not the ones you scripted beforehand. If further treatment is needed, he/she can advise you on the next steps.
There are tests available online, including one called “3 Minute Depression Test.” Tests like these are convenient, private (unless you’re being hacked), and often free. That can be a good place to start. However, that is hardly enough for a diagnosis of major depression or any of the possible physical causes. Getting the right help will involve seeing a doctor at some point. And after that, you’ll probably need to see a therapist or counselor for a while. I don’t see how any self test can tell you if you need it. But if the results prompt you to talk to your doctor, then it’s served a purpose.
I think this sums up the standard advice on getting tested. However, this kind of screening is about situational depression, not clinical depression. We need to think of that as something separate from standard screening for depression.
Testing for Clinical Depression
The questions in most screenings are about how you have been feeling recently. Getting tested for clinical depression is different. When I got tested, the therapist did not ask anything about how I was feeling. The test involved going through different tasks and explaining why I did it this way. So it is about how your brain responds to different puzzles and challenges. This makes sense, because clinical depression is not about how you are feeling at the moment or in the past few weeks. It is about how your brain works. This is why clinical depression is harder to detect than situational depression. It requires a trained professional test for it.
When I was diagnosed, I only felt mildly depressed. It seemed odd to me that my mother and sister were pushing me to get tested. There were times in my life when I had much worse depression, so why are they bringing it up now? I would have said at the time that I was mildly depressed. And why not? I was in my early thirties, unemployed, and never had a girlfriend. Who wouldn’t be at least a little depressed? I didn’t think depression was something that needed to be addressed before finding a job. But my sister said to me, “I have always experienced you as being depressed.”
That got my attention. She has known me for a long time. She knew things about me no one else did. The same is true of my mom. If they are seeing something, maybe I should at least look into it. Since I was unemployed, my mom agreed to pay for it. The testing took about two or three hours, which is another reason why I don’t think a three minute test is enough for diagnosis. I’m not saying don’t use that tool if you suspect you are depressed. Just remember it is only one step in the process of being diagnosed.
Wouldn’t You Know If You Are Depressed?
Not necessarily. Remember I said I only felt mildly depressed when I got tested? Here is how the therapist summed up the results. “You tested high for depression in every possible way.”
What? High in every way? How is that possible?
I only felt mildly depressed. On a scale of one to ten, I was at a two, maybe three. And still, I tested high in every possible way. This was probably the greatest shock of my life. And it’s how I learned the difference between situational depression and clinical depression. The therapist explained to me that the brain naturally produces antidepressant chemicals like serotonin, dopamine, and norepinephrine. When it doesn’t get enough of these chemicals, you have clinical depression. While situational depression is about how you feel over a period of a few weeks or sometimes months, clinical depression is a condition of the brain. No matter how you feel—happy, sad, hopeless, confident, angry, peaceful—it is always with you.
While you may think you have highs and lows like everyone else, your lows are lower because of your brain chemistry. While situational depression is usually triggered by something that got you down, with clinical depression, you can be depressed even when you know you have no reason to be. Again, that is because of your brain chemistry. It’s not your fault, and it is treatable.
It’s important to note not everyone who is depressed is clinically depressed. While some experts question a definition of depression that is based on brain chemistry, I still believe it was a major factor in my case. It was hard to take in at first. But once I accepted it, the path to recovery became much clearer.
Next Post: Getting Treatment
So I had my diagnosis, clinical depression. The next step was to get treatment. That usually means medication and counseling. I’ll talk about that in more detail in the next post.
To sum up so far,
- Getting help for depression will most likely involve your doctor and a counselor. Understand they each have different roles to play.
- Your doctor can test for various physical illnesses that could be behind your depression symptoms. Treating anything that comes up from that might clear up your depression.
- Your doctor can screen you for depression and tell you if the tests indicate a need for further treatment. He/she cannot give professional counseling but may be able to recommend a counselor to you.
- Only a trained mental health professional can test specifically for clinical depression. If your doctor (or mother or sister) recommends testing for it, take his/her advice, even if you don’t think depression is that serious a problem for you at the moment.
- A mental health professional cannot test for physical illnesses. That’s something for your doctor.
- Your doctor might recommend counseling. However, you don’t need a doctor’s order to get counseling. If you feel like you need it, you are probably right.
- Even if you don’t feel like you need counseling or testing, but people close to you who have your best interests at heart think you do, consider that they may be right. I didn’t get tested for clinical depression because I felt like I needed it. I got tested because my mother and sister thought I needed it.
Grace and Peace to you.
P.S. I haven’t tried online counseling. But if you’re interested, this link will take you to a site that lists and ranks some of the most popular sites.
E-Counseling.com. “Top Online Therapy Services—February 2020.” https://www.e-counseling.com/tlp/online-therapy/?imt=1
WebMD. “Tests Used to Diagnose Depression.” https://www.webmd.com/depression/guide/depression-tests#1