Tests

No blood test, X-ray, or physical exam will provide a definitive diagnosis of depression. But typically the first step in determining whether someone is depressed is a physical examination. Certain medications and medical conditions can cause or contribute to symptoms of depression, and these factors first should be ruled out through a physical examination and lab tests.

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The next step will be an extensive conversation with a doctor or mental health practitioner. A series of questions known as the Beck's inventory often are used to distinguish a real depression from transient unhappiness.

The diagnostic evaluation will include a complete history of symptoms--when they started, how long they have lasted, how severe they are, and whether the patient had them before. Any changes in sleeping or eating patterns are important to note. Two critical factors in determining whether or not someone is suffering from clinical depression are how much the symptoms interfere with normal life and how long the symptoms have lasted.

The physician also should ask about family history, life events that may have contributed to the depressed state, alcohol or drug use, and whether the person has had thoughts about death or suicide. Mental status should also be a part of this examination because a change in speech, thought patterns, or memory could all be symptoms of depression as well.