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Things You Should Know About the Diagnosis of Depression

Information about how depression is diagnosed, including the official DSM-IV diagnostic criteria, the signs and symptoms to look for and the most common types of depression diagnoses.

How Is Depression Diagnosed?

Currently, no laboratory test can be used to diagnose depression. Depression is diagnosed based on your reported symptoms, signs that your doctor observes while interviewing you, your medical history and your family's medical history. Criteria outlined in a handbook called the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are used in making the diagnosis.

What Are the DSM-IV Criteria?

The Diagnostic and Statistical Manual of Mental Disorders is a book which defines the criteria by which mental disorders such as depression are diagnosed. The fourth edition is currently in use so it is often referred in short as the DSM-IV.

What Are the Main Types of Depression?

Depressive disorders fall into three categories -- major depressive disorder, dysthymic disorder and depressive disorder not otherwise specified. The latter category includes disorders which do not fit into the first two (e.g. premenstrual dysphoric disorder). Specifiers describe the nature of the most recent episode of depression (for example, "atypical features" or "postpartum onset") or the course of the illness over time (for example, "seasonal pattern"). Depression may also be part of bipolar disorder, in which a patient experiences alternating periods of depression and mania.

What Are the Symptoms of Depression?

If you have experienced five or more of these symptoms within the same two-week period -- especially if a depressed mood or loss of interest or pleasure are among your symptoms -- this could indicate an episode of depression. The symptoms should not be accounted for by another illness, drugs of abuse or prescription medications.


Can a High Carb Diet Take Off the Pounds?

Weight gain is a side-effect that is common to many antidepressants, mood stabilizers and antipsychotics. As much as we know about the adverse effects that obesity can have on health, the more pressing need to get our moods under control takes precedence when a patient feels that they can't go on living. But what about after a patient's mood becomes stabilized? What can be done to prevent excess pounds from undermining health and self-image?

One obvious solution is to switch to a medication which causes less weight gain, but this may not work in every case. People are very individual in which medications will relieve their depressive symptoms and these medications may not provide an adequate solution.

According to Judith Wurthman, Ph.D. director of the Triad Weight Management Center at McLean Hospital in Belmont, Mass., carbohydrate control is a key component in weight control for those using psychotropic medications.

Dr. Wurthman says that patients who gain weight on these medications typically have an uncontrollable urge to eat starchy or sweet foods. She says that the answer is to consume carbohydrate-rich, protein-poor foods, which will increase brain levels of tryptophan and serotonin synthesis, in turn reducing the craving.

The regimen advocated by Dr. Wurthman's center involves a proprietary drink containing 40g simple and complex carbohydrates two to three times a day on an empty stomach. She further counsels her patients to have a high-carbohydrate, low-protein, low-fat meal in the evening, when cravings may be strongest. Out of the people who have completed a fourteen week program of carbohydrate drink, diet and exercise though her center, the average weight loss reported was 20 lbs.

Dr. Wurthman is also the author of "Managing Your Mind and Mood Through Food", which outlines an eating plan designed to aid readers with stress and mood management through dietary choices.

Styles of Procrastination; Time Management Tips

Never do today what you can put off for tomorrow. Better yet, never put off 'til tomorrow what you can avoid altogether!

I don't know who coined these phrases, but they must have been a depressive. The symptoms that we face, such as fatigue and hopelessness, make it so easy to say to ourselves, "I'll just put this off until tomorrow when I feel better". Before we know it, that deadline is creeping up on us and we're starting to panic. What's the best way to deal with panic? Hide your head in the sand and hope it goes away! Not really, but procrastination an easy habit to fall into and as the panic mounts, so does the depression. The more depressed we get, the more we avoid reality.

Why We Procrastinate

Why do we fall into the procrastination trap time after time? Because procrastination becomes a way--no matter how maladaptive-- of coping with the emotions and physical symptoms that accompany depression. It may bring some temporary relief, but we eventually wake up the following day and find that no brownies have dropped in overnight and done our work for us.

Which style of procrastination fits you?

  • Organizing thoughts and actions and keeping on track with plans is difficult. (People with ADD/ADHD may fall into this category.)
  • Tasks seem overwhelming so it's futile to even try.
  • Hostile feelings towards someone cause you to want to punish them by putting things off.
  • Routine and schedule causes you to feel rebellious.
  • You fear disapproval.

These procrastination styles can overlap in one of four themes:

Self-Doubt - These people feel there are rigid standards about how thing ought to be done and they fear they will fail. They second-guess themselves and delay taking action.

Discomfort Dodging - This person avoids activities that will cause them distress, discomfort or anxiety. Rather ironically, the act of dodging the activity doesn't make it go away so tensions mount because of this avoidance.

Guilt-Driven - The person feels guilt over tasks undone, but rather than correct the original lack of action continues to procrastinate in order to not face up to the guilt feelings.

Habitual - The person has procrastinated so many times, it becomes an ingrained response. The person no longer thinks about why they do it, they feel it's just a part of themselves. It becomes an automatic response to say, "This is too hard", "I'm too tired", or to laugh it off as a character flaw.

Once you recognize your style of procrastination, you can take steps to stop it.

Time Management Tips to Beat Procrastination

One of the most important things you an do for yourself is to get organized. Make lists, take a class in organization, or purchase an organizer. Do whatever works for you. One word of advice: follow the KISS principle (Keep it Simple, Stupid). If your organization system is too complicated, it will become just another task to avoid. Here's my own system. You are welcome to use it if it works for you.

  • Make a list of what needs to get done. This can be listed in no particular order and will give you a handle on just what you need to accomplish.

  • Prioritize these. My way of doing this is by deadlines. I arrange them in order of when they are due. You may also choose to rank them by how important it is to get them done. For example, paying your bills on time may be more important to you than cleaning out your closets. Do that first.

  • Get yourself a calendar with room to write notes in. I personally use a bound notebook and write in dates as I go. I make pages with dates for long-term planning and also keep a separate list that I transfer my short-term goals to.

  • Take what's at the top of your priority list and determine how long it will take to accomplish it. If it's a quick task, put that down to be done the current day. If it will take a longer time, divide it into smaller tasks to be spread out over several days. Write this in your calendar with specific dates for accomplishing each. Include your deadline for completion of this task on your calendar as well.

  • Keep filling your calendar until you have a time set aside to do each item while still meeting your deadlines. Be careful to not overbook yourself and allow plenty of time for delays. This will allow you to feel confident that you can accomplish all you need to in the time you have. Now you can relax and work on one item at a time without feeling you have to do it all at once.



Is There a Screening Test for Depression?

While a screening test can't diagnose depression, it can help familiarize you with the symptoms of depression so that you can determine if you may need to seek professional help.

I Think I'm Depressed, Whom Should I See to Get a Diagnosis?If your score on the screening test indicates that you may have symptoms of depression, your next step is to see a doctor. But you may have questions about what kind of doctor to visit. This article will help you understand how to get proper diagnosis and treatment.

Whom to See If You Suspect You Are Depressed

So you've decided you need to see someone for your depression. Now what?

Your first visit should be to your family doctor for a thorough checkup. There are several medical conditions that can cause depression symptoms, such as vitamin and mineral deficiencies, female hormonal changes and thyroid conditions. In addition, several medications may have depression as a side-effect. If your doctor does not find any of these factors as a cause of your depression, you may then be referred to a mental health professional.

It is very important--especially if this is your first time seeing someone for depression--that you obtain a referral. Your family doctor may mean well in offering to prescribe you an antidepressant, but he is not qualified to treat depression. He cannot offer you psychotherapy nor is he experienced in the nuances of prescribing psychotropic medications.

Psychiatry is very much an art rather than a science. Treating depression is not quite a simple as giving someone a prescription for Zoloft and sending them on their way. Some will need several trials of different medications to find one that best relieves their symptoms. Some will need more than one medication to counteract side-effects or boost positive effects. Still others might benefit from adding psychotherapy to the mix. In addition, you may have a completely different disorder. Bipolar disorder is one such disorder which may be initially misdiagnosed as depression, but requires a very different course of treatment.

There will be a tendency for some new patients to visit a counselor or psychologist for their initial evaluation rather than a psychiatrist. This can be beneficial for many, but for others it is not enough. Only a psychiatrist is a medical doctor and therefore able to prescribe medications. If your depression stems from a chemical imbalance, talk therapy will not be sufficient to treat you. It is best to make your initial visit to a psychiatrist, who can both prescribe medications and offer you psychotherapy if it is needed. This two pronged approach of medication and talk therapy is often the most beneficial to patients.

Although your psychiatrist is qualified to offer you psychotherapy services, do not be surprised if he refers you to a second, non-medical professional for your therapy while he concentrates on fine-tuning your medications. There is some debate within the psychiatric community as to whether the role of psychiatrist as a talk therapist has become outdated as we learn more about the biological basis of depression and mental illness. Some argue that therapy can be left to the psychologists while the psychiatrist concentrates on the complexities of the patient's medical care. At the present time, however, psychotherapy is a part of the psychiatrist's training and he is fully qualified to offer it to patients if he so chooses.

The most important thing to remember about seeking depression treatment, however, is simply to speak up and ask. Depression is not a sign of weakness or laziness. It is a sign that something is out of balance. With proper treatment, you can feel well again.