Loading ...The first step to obtaining appropriate treatment is a complete physical and psychological evaluation to determine whether the person may have a depressive illness, and if so, what type. Certain medications, as well as some medical conditions, can cause symptoms of depression. Therefore, the examining physician should rule out (exclude) these possibilities through an interview, physical examination, and laboratory tests.
A thorough diagnostic evaluation includes a complete history of the patient’s symptoms:
- 1. When did the symptoms start?
2. How long have they lasted?
3. How severe are they?
4. Have the symptoms occurred before, and, if so, were they treated and what treatment was received?
The doctor should ask about alcohol and drug use, and whether the patient has had thoughts about death or suicide. Further, the history should include questions about whether other family members have had a depressive illness, and if treated, what treatments they received and which were effective.
A diagnostic evaluation also includes a mental status examination to determine if the patient’s speech, thought pattern, or memory has been affected, as often happens in the case of a depressive or manic-depressive illness. As of today, there is no laboratory test, blood test, or x-ray that can diagnose a mental disorder. Even the powerful CT, MRI, SPECT, and PET scans, which can help diagnose other neurological disorders, such as stroke or brain tumors, cannot detect the subtle and complex brain changes in psychiatric illness. However, these techniques are currently useful in research on mental health and perhaps in the future they will be useful for diagnosis as well.
