Depression Diagnosis: Who Does It and How?

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Apr 21, 2022

✨POV✨: You've taken a bunch of quizzes to help you make sense of your thoughts and feelings. The burning question you're trying to answer is - are these symptoms of depression? But you are also wondering if the quizzes are enough to tell you whether you have depression or not.

Short answer short, absolutely not. Do not rely on those quizzes or articles to tell you if what you're thinking and feeling is depression or not; leave that up to the experts in the field.

The Clinical Depression Diagnosis 📝

Depression diagnosis is not as understood or known about as depression itself. There are so many questions surrounding it that don't make the cut to pop psychology.

What are the different types of diagnoses for clinical depression?

Who can do it?

How do they do it?

The answers to these questions lead us to the greatest answer of all - the way to treat depression.

Mental health and everything surrounding it have been hush-hush for so long that we've gotten used to relying on ourselves to figure it out. But that's exactly what we need to undo - mental health is as important as physical health and every question (and feeling and thought) about it deserves to be answered (by someone who knows the answer).

Does the Depression Diagnosis Matter? 🗝️

If we do have quizzes and if depression is a subjective experience, why aren't they enough?

Because we don't know who created those quizzes. It could be anyone - high school students who based their quiz questions on a few hours of research or a content creator who has 0 background in the field. There's a reason that these quizzes are not considered legitimate by mental health professionals - because they are neither standardized nor verified.

Articles about depression symptoms may not be comprehensive. They definitely help us build awareness and find direction, but that's all they are. It can be tempting to self-diagnose after reading tens of articles, but that's when we know that we need someone to do the real diagnosis. Like a doctor, who has spent years of energy mastering this skill.

Clinical depression has fazed people who experience it and the experts who study it - because it is a complex phenomenon that we are still learning to understand and heal. The experts obviously have a much better grasp because they have spent years training for it and that’s what makes them better judges of mental illness.

The merit of self-sufficiency is so drilled into us that even when we're experiencing difficult or uncomfortable emotions, we find ourselves trying to figure out depression through (potentially spurious) sources on the internet. That's like us trying to stitch up our own wounds or like a truck of information knocking us over.

Taking help when needed (from someone who knows how to help us) may not be a skill that is taught to us well, but it is one that the world is waking up to. So the next time we have a thought like, ‘I just don't feel like doing anything’, we can do a mini-therapy instead of rummaging on the internet, or directly contact a mental health friend.

And funnily enough, practicing this interdependence is what makes us self-sufficient.

Who Diagnoses Depression? 🧑🏼‍⚕️

The experts in the field of mental health are, wait-for-it, mental health professionals. But, there are many kinds of mental health professionals and not all can diagnose.

The three main kinds of mental health professionals are:

💊 A Psychiatrist

Aka the Dr. of mental health.

Psychiatrists are trained in medical school, making them doctors who can diagnose disorders, prescribe medication, and provide therapy. They study for 12 years to become a licensed and practicing psychiatrist (aka doctors who are extensively trained in their roles of diagnosis and treatment of mental disorders).

🩺 A Clinical Psychologist

Aka a therapist.

Clinical psychologists are specifically trained in the field of mental disorders, can diagnose depression symptoms (along with a host of other mental disorder diagnoses), and provide therapy for the diagnosis. They study for a minimum of 8 years to become practicing psychologists.

🗣️ A Counseling Psychologist

Aka another type of therapist.

Counseling psychologists cannot diagnose mental disorders. They are exclusively trained in counseling and therapy and study for a minimum of 6 years. They generally work with people who are struggling with mental health but do not have a specific mental illness. To know more about the difference between therapy and counseling, click here.

How Do They Diagnose? ☑️

The bible of mental disorders and diagnoses is the Diagnostic and Statistical Manual (DSM), which was written by the American Psychiatric Association (APA). It is regularly updated to include any new findings in research - new disorders and symptoms.

The DSM-5-TR (the current version) lists different mental disorders and their diagnostic criteria (the criteria a condition must meet to be diagnosed as that disorder). Diagnostic criteria list symptoms, how many must be present to qualify as the disorder (and for how long), and how the severity of the disorder can be gauged. A symptom that must be present for a depression diagnosis is experiencing a ‘depressed mood’ for at least two weeks.

Diagnosis of depression is not only dependent on the DSM - a psychiatrist or clinical psychologist may also want to use tests like the Patient Health Questionnaire, Beck's Depression Inventory, or Hamilton Rating Scale for Depression to understand the condition more deeply.

Some Depression Diagnoses 📃

There are over eight different types of depressive disorders listed in the DSM. Click here to see the whole list.

For each type of depression, based on the symptoms we have and their severity, the kind of treatment we'll get is different.

Some are more common than others. Here are a few of them:

🥇 Major Depressive Disorder aka Severe Depression

Major depression (MDD) has severe symptoms which include emotional as well physical symptoms. This type of depression is easier to diagnose as the symptoms tend to disrupt day-to-day life in a noticeable way.

MDD is diagnosed on the basis of depressive episodes that can last anywhere between 2 weeks and 6 months.

🥈 Persistent Depressive Disorder aka Mild Depression

Persistent Depressive Disorder (PDD) has milder symptoms than MDD, which do not manifest physically and are only emotional. This type of depression is harder to diagnose because of its milder symptoms, which may be harder to pinpoint. PDD can manifest as high-functioning depression (the kind that does not lead to a total disruption of our life).

PDD symptoms must be present for the majority of two years to be diagnosed.

🥉 Treatment-Resistant Depression

Treatment-Resistant Depression is a type of major depression that does not respond to therapy and antidepressant medication. This type of depression requires brain stimulation therapies like electroconvulsive therapy, which directly works with the brain to improve its function.

Last Word on Mental Health 🤍

Recap time.

Today we learned that depression is a complex phenomenon that needs diagnosis for treatment. Because we need to know which type of depression it is, to get the treatment we need - what type of therapy and if we need medication.

And whodunit? Not us, for sure.

And always remember, depression is the name of those skeletons in our closet that look scarier than they really are when we zoom in.

Note on Mental Disorders 🚩

Clinical Depression is never clear cut, making it harder to diagnose and treat. It is not unheard of for people with depression to self-harm or have suicidal thoughts. If you have such depressive symptoms, please use the national suicide prevention lifeline or contact a mental health professional to seek treatment options.

Some of the other clinical depression diagnoses are bipolar disorder, premenstrual dysphoric disorder, disruptive mood dysregulation disorder and seasonal affective disorder (aka seasonal depression).