What is the process for diagnosing and treating an individual with depression?

Diagnoses of depression are made by a healthcare professional, such as a GP, psychiatrist, mental health nurse or a clinical psychologist. The healthcare professional will conduct a clinical interview asking the individual about the nature, severity, and length of the problems they have noticed, information about the individual’s (and their family’s) medical history and social situation. The healthcare professional may also ask the individual to fill in a questionnaire. The healthcare professional will compare this information to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or to the International Classification of Diseases (ICD-11) to identify whether the individual meets the criteria for a diagnosis of major depressive disorder. A physical examination with a medical doctor may also be needed to rule out alternative medical conditions. This may involve blood tests or other physical health tests.

Major depressive disorder is just one type of mental health conditions, and some of the problems an individual may be experience could overlap with other mental health conditions, such as:

– Bipolar disorder

– Dysthymia

– Adjustment disorder with depressed mood

– Anxiety disorders

– Seasonal Affective Disorder (SAD)

– Complex post-traumatic stress disorder (CPTSD)

And this is not an exhaustive list. It is also important to remember that depressed mood may also be a sign that an individual is genuinely not happy with their current life situation, for example, the individual may be frustrated that they cannot meet meaningful goals, and that they need to rethink their approach to certain situations. Depressed mood does not always mean that an individual has a diagnosis of a mental health condition.

Scientific studies have shown that psychological therapy can be effective for treating depression (with a small to medium effect size when accounting for publication bias, for those familiar with statistics). Therapeutic alliance and engagement, or participation, in the therapeutic process have been found to be strong predictors of outcome. The National Institute for Health and Care Excellence (NICE) suggests considering the benefits or guided self-help, group and individual psychological therapy, group exercise, group mindfulness and meditation and antidepressant medication (selective serotonin reuptake inhibitors – SSRIs). Research shows that the combination of psychological therapy and pharmacotherapy (e.g., use of antidepressant medication) can be the best choice for patients with moderate depression to improve quality of life.

There are several lifestyle changes that may help ease depressive symptoms. One of these is regular exercise, for example, 30 minutes of moderate exercise (whether that be brisk walking, jogging, cycling, swimming, or another form of activity) every day. This may seem daunting at first but starting with something gentle and realistic can help an individual experience a sense of achievement and mastery. Getting enough rest and sleep and eating a healthy diet that maintains energy levels are an important part of this process. Another important factor to help improve mood is being socially active – spending time with others such as family and friends can increase feelings of connection and belonging and a sense of being loved and cared for. One last point – remember that consumption of drugs or alcohol can make depression worse. So there is lots that you can do for yourself outside of your psychological therapy sessions and or while you wait for medication to take effect.