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Tests and diagnosis

By Mayo Clinic staff

Managing Depression

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These exams and tests can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and check for any related complications:

  • Physical exam. Your doctor may do a physical exam and ask in-depth questions about your health to help determine what may be causing your depression. In some cases, depression may be linked to an underlying physical health problem.
  • Lab tests. For example, your doctor may do a blood test called a complete blood count (CBC) or test your thyroid to make sure it's functioning properly.
  • Psychological evaluation. To check for signs of depression, your doctor or mental health provider will talk to you about your symptoms, thoughts, feelings and behavior patterns. Your doctor may have you fill out a written questionnaire to help answer these questions.

Diagnostic criteria for atypical depression
To be diagnosed with atypical depression, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association.

For a diagnosis of atypical depression, you must first meet the general DSM criteria for major depression — such as feeling down most of the day and losing interest or pleasure in activities you once enjoyed. You'll also need to meet other specific criteria for atypical depression.

For a diagnosis of atypical depression you must have this symptom:

  • Depression that temporarily lifts when you're cheered up by positive events

In addition, you must have at least two of these symptoms for diagnosis:

  • Gaining weight or having a noticeable increase in appetite
  • Sleeping too much
  • Being sensitive to rejection by others so that it affects your work or relationships
  • Having a heavy feeling in your arms and legs

Atypical depression has a specific definition as a diagnosable condition. But some doctors and mental health providers use the term more loosely. Ask for a definition if it isn't clear what your doctor or mental health provider means when he or she says "atypical depression."

Treatments and drugs Preparing for your appointment
References
  1. O'Keane V, et al. A review of atypical depression in relation to the course of depression and changes in HPA axis organization. Psychoneuroendocrinology. 2012. In press. Accessed June 19, 2012.
  2. Atypical features specifier. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 19, 2012.
  3. Cizza G, et al. Clinical subtypes of depression are associated with specific metabolic parameters and circadian endocrine profiles in women: The power study. Plos One. 2012. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0028912. Accessed June 19, 2012.
  4. Pae C, et al. Atypical depression: A comprehensive review. CNS Drugs. 2009;2:1023.
  5. Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/index.shtml. Accessed June 19, 2012.
  6. McPhee SJ, et al. Current Medical Diagnosis & Treatment. 51st ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=13381. Accessed June 20, 2012.
  7. Parker G, et al. Will a new genotyping test help the clinician predict response to antidepressant drugs? Australasian Psychiatry. 2010;18:413.
  8. Deplin (Prescribing information). Covington, La.: Pamlab; 2011. http://www.deplin.com/. Accessed Aug. 27, 2012.
  9. Kung S (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 7, 2012.
  10. Understanding major depression. National Alliance on Mental Health. http://www.nami.org/Template.cfm?section=Search&Template=Search/SearchDisplay.cfm. Accessed June 20, 2012.
  11. Indications for electroconvulsive therapy (ECT) in unipolar depression and its efficacy. http://www.uptodate.com/index. Accessed June 20, 2012.
  12. Carpenter DJ. St. John's wort and S-adenosyl amethione as "natural" alternatives to conventional antidepressants in the era of the suicidality boxed warning: What is the evidence for clinically relevant benefit? Alternative Medicine Review. 2011;16:17.
  13. Lamers F, et al. Stability and transitions of depressive subtypes over a 2-year follow-up. Physiological Medicine. 2012. In press. Accessed June 19, 2012.
  14. Hourani LL, et al. Influence of spirituality on depression, posttraumatic stress disorder, and suicidality in active duty military personnel. Depression Research and Treatment. 2012;2012:1.
  15. Depression and complementary health practices: What the science says. National Center for Complementary and Alternative Medicine. Dec. 2011. http://nccam.nih.gov/health/providers/digest/depression-science.htm. Accessed May 10, 2012.
  16. Viibryd (prescribing information). St. Louis, Mo.: Forest Pharmaceuticals; 2011. http://www.viibryd.com/. Accessed June 20, 2012.
  17. SAMe. Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=MAYO&s=ND&pt=100&id=786&ds=adverse&lang=0. Accessed Aug. 3, 2012.
  18. Papakotas GI, et al. Folates and s-adenosylmethionine for major depressive disorder. Canadian Journal of Psychiatry. 2012;57:406.
  19. Marchand WR. Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression. Journal of Psychiatric Practice. 2012;18:233.
  20. Tanyi RA, et al. The effects of psychoneuroimmunology (PNI) based lifestyle intervention in modifying the progression of depression in clinically depressed adults. International Journal of Psychiatry in Medicine. 2011;42:151.
  21. Wu J, et al. Acupuncture for depression: A review of clinical applications. The Canadian Journal of Psychiatry. 2012;57:397.
  22. Chi J, et al. Tai chi and reduction of depressive symptoms for older adults: A meta-analysis of randomized trials. Geriatrics & Gerontology International. 2012. In Print. http://www.ncbi.nlm.nih.gov/pubmed/22680972. Accessed Aug. 28, 2012.
  23. Chan MF, et al. The effectiveness of music listening in reducing depressive symptoms in adults: A systemic review. Complementary Therapies in Medicine. 2011;19:332.
  24. McCaffrey R, et al. Garden walking and art therapy for depression in older adults: A pilot study. Research in Gerontological Nursing. 2011;4:237.
DS01181 Sept. 20, 2012

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