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Tests and diagnosis
By Mayo Clinic staffWhen a doctor suspects a teen has depression, he or she will generally ask a number of questions and may do medical and psychological tests. These can help rule out other problems that could be causing symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:
- A physical exam. This generally involves measuring height and weight; checking vital signs, such as heart rate, blood pressure and temperature; listening to the heart and lungs; and examining the abdomen.
- Psychological evaluation. To check for signs of depression, your doctor or mental health provider will talk to your teen about his or her thoughts, feelings and behavior patterns. The doctor may have your teen fill out a written questionnaire to help answer these questions.
Diagnostic criteria for depression
To be diagnosed with depression, your teen must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
For a diagnosis of major depression, your teen must have five or more of the following symptoms over a two-week period. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Symptoms can be based on your teen's feelings or may be based on the observations of someone else. They include:
- Depressed mood most of the day, nearly every day, such as feeling sad, empty or tearful (in teens, depressed mood can appear as constant irritability)
- Diminished interest or feeling no pleasure in all — or almost all — activities most of the day, nearly every day
- Significant weight loss when not dieting, weight gain, or decrease or increase in appetite nearly every day (in teens, failure to gain weight as expected can be a sign of depression)
- Insomnia or increased desire to sleep nearly every day
- Either restlessness or slowed behavior that can be observed by others
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness, or excessive or inappropriate guilt nearly every day
- Trouble making decisions, or trouble thinking or concentrating nearly every day
- Recurrent thoughts of death or suicide, or a suicide attempt
To be considered major depression:
- Symptoms aren't due to a mixed episode — mania along with depression that sometimes occurs as a symptom of bipolar disorder
- Symptoms must be severe enough to cause noticeable problems in day-to-day activities, such as school, social activities or relationships with others
- Symptoms are not due to the direct effects of something else, such as drug abuse, taking a medication or having a medical condition such as hypothyroidism
- Symptoms are not caused by grieving, such as temporary sadness after the loss of a loved one
Other conditions that cause depression symptoms
There are several other conditions with symptoms that can include depression. It's important to get an accurate diagnosis so your teen can get the appropriate treatment. Your doctor or mental health provider's evaluation will help determine if the symptoms of depression are caused by one of the following conditions:
- Adjustment disorder. An adjustment disorder is a severe emotional reaction to a difficult event in your life. It's a type of stress-related mental illness that may affect your feelings, thoughts and behavior.
- Bipolar disorder. Bipolar disorder is characterized by mood swings that range from the highs of mania to the lows of depression. It's sometimes difficult to distinguish between bipolar disorder and depression, but it's important to get an accurate diagnosis because treatment for bipolar disorder is different from that for other types of depression.
- Cyclothymia. Cyclothymia (si-klo-THI-me-uh), or cyclothymic disorder, is a milder form of bipolar disorder.
- Dysthymia. Dysthymia (dis-THI-me-uh) is a less severe but more chronic form of depression. While it's usually not disabling, dysthymia can prevent your teen from functioning normally in his or her daily routine and from living life to its fullest.
- Postpartum depression. This is a common type of depression that occurs in new mothers. It often begins four to eight weeks after delivery and may last for months.
- Psychotic depression. This is severe depression accompanied by psychotic symptoms such as delusions or hallucinations.
- Schizoaffective disorder. Schizoaffective disorder is a condition in which a person meets the criteria for both schizophrenia and a mood disorder.
- Seasonal affective disorder. This type of depression is related to changes in seasons and diminished exposure to sunlight.
Make sure that you understand what type of depression your teen has so that you can learn more about his or her specific situation and its treatments.
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