It is not good for my stress level and blood pressure that I am often told by colleagues that a patient’s diagnosis is “depression” or “anxiety” or, worst of all (but not rare!), “anxiety and depression.” I’m assuming you hear this often as well?
Right away, we would want to know the following:
1. What KIND of depression (or anxiety)?
Many people think wrongly that we have to treat the patient’s suffering and either we can’t know or it doesn’t matter what kind of depression the patient has. This kind of thinking is probably responsible for such widespread use of antidepressant medications in:
– Patients with bipolar depression.
– The general population. In 2021, about 14% of all adult women and 7% of all adult men among the civilian, noninstitutionalized U.S. population were taking a prescription medication for “depression” (Quickstats, 2023).
2. What is the person depressed (or anxious) ABOUT?
The patient may say that there is nothing that they are depressed or anxious about, but we should at least ask. I find that many patients whom I evaluate point to specific things that they rightly or wrongly consider to be the reason(s) for their depression or anxiety symptoms. Those factors may not be the whole story, but they are usually relevant, both for understanding the patient’s symptoms and for helping the patient.
Next, please see the following article on this website:
Understanding the diagnosis of Persistent Depressive Disorder (DSM-5-TR®)
Related Pages
Depressive Disorders–Diagnosis and Assessment
Let’s not say that the diagnosis is “Depression” or “Anxiety”
A Deeper Understanding of the DSM-5-TR® Criteria for Major Depressive Disorder
Grief versus Major Depression
Tips on differentiating unipolar from bipolar depression
Understanding the diagnosis of Persistent Depressive Disorder (DSM-5-TR®)
“Specifiers” for mood disorders
How to diagnose atypical features in depressive and bipolar disorders
What to assess for if atypical features are present in a depressive episode
Understanding “mixed features” in episodes of mood disorders
Anxious distress (in depressive episodes)
Cognitive dysfunction in major depressive disorder
Excessive daytime sleepiness after remission of major depression
Can beta-blockers cause depression or is this a myth?
Seasonal Affective Disorder
Can oral contraceptives cause or worsen depression?
How to diagnose premenstrual dysphoric disorder (PMDD)
References
QuickStats: Age-Adjusted Percentage of Adults Aged ≥18 Years Who Take Prescription Medication for Depression, by Sex and Race and Hispanic Origin — National Health Interview Survey, United States, 2021. MMWR Morb Mortal Wkly Rep 2023;72:591. DOI: http://dx.doi.org/10.15585/mmwr.mm7221a5.
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