Diagnosis

The first step to getting appropriate treatment, for depression or any emotional problem, is a complete psychological evaluation to determine whether you have a depressive illness, and if so, what type of depression. Consultation with a psychologist will include a review of your physical health history. Some medications as well as some medical conditions can cause symptoms of depression, so your psychologist will ask your family physician to rule out these possibilities if other physical symptoms are evident. However, physicians often focus only on the physical aspects of depression, and may prescribe medication without referring you for psychological treatment or evaluation. If you experience the symptoms of depression, as described on this website, you should talk to a psychologist, to assess whether psychological treatment is indicated, even if it not suggested by your physician. As a general rule, you should never take antidepressant medication alone, without also beginning psychotherapy, or at least seeing a psychologist for an evaluation. A good psychological diagnostic evaluation will include a complete history of your symptoms, i.e., when they started, how long they have lasted, how severe they are, whether you've had them before and, if so, whether you were treated and what treatment you received. Your psychologist should ask you about alcohol and drug use, and if you have had thoughts about death or suicide. Further, a history should include questions about whether other family members have had depression and if treated, what treatments they may have received and which were effective. Lastly, the psychological diagnostic evaluation will include a mental status examination to assess the full range of psychological symptoms and problems. This will help identify any other psychological problems that might be present, and will help determine the most appropriate treatment for you. Treatment choice will depend on the outcome of the evaluation. Most people do well with psychotherapy, but some require treatment with antidepressants in addition to psychotherapy. Medication can allow you to to gain relatively quick symptom relief, if you are experiencing severe and disabling symptoms. However, medication does not "cure" the depression, it only treats the symptoms. If you are depressed, you need psychotherapy to help you to learn more effective ways to deal with life's problems, and to change the negative thoughts and attitudes that have caused you to develop depression.