Seek medical attention
When consciously experiencing long-term depression, lack of interest in everything, or decreased interest, or even with suspected symptoms of depression such as slow response, delayed thinking, and memory loss, you should seek medical help in time. In addition, family members or relatives find that their loved ones, When a friend has the aforementioned behavior, he should also be actively encouraged to seek medical treatment.
For patients who have been diagnosed with depression, they should strictly follow the doctor's advice and insist on regular follow-up visits. Even if the condition has been effectively controlled after treatment, if there is a major change in life or if there are signs of depression, they should also seek medical treatment in time.
Diagnosis process
Generally speaking, the doctor first needs to fully understand the patient’s medical history, including but not limited to the current medical history, existing symptoms, whether there are self-harming or suicidal thoughts and behaviors, whether there has been a history of manic episodes or episodes of psychotic symptoms, and current treatment conditions And the efficacy, previous treatment methods, drug/psychoactive substance use, personal history, family history, etc.
Since the etiology and pathogenesis of depression are not yet clear, the diagnosis of depression mainly depends on a comprehensive assessment of the patient, and then based on its clinical manifestations, course of the disease, and the severity of symptoms, in order to exclude substances, drugs, or other physical problems. After depression, the disease is diagnosed.
Treatment department
You can go to the psychiatric hospital, mental health center, general hospital psychiatry or psychology department and other relevant departments for treatment.
Related inspections
Mental examination
The doctor will mainly pay attention to the patient's mental and emotional conditions.
Understand the patient's consciousness, orientation, attention, thinking ability, memory, feeling, perception, intelligence and insight.
Understand the patient's emotional activities, will and daily behavior, etc., especially pay attention to the patient's emotions.
Assess whether the patient is accompanied by mania, cognitive deficits and psychotic symptoms, assess the patient's risk of suicide and violence, and comorbidity with other mental disorders.
Evaluation tool
Standardized patient self-rating scales and clinical other scales are commonly used in clinical practice to assess the severity of depressive symptoms in patients. Among them, the self-rating scale plays an important role in screening and evaluating depression in the population.
Self-rating scale
9-item Simple Patient Health Questionnaire (PHQ-9);
Zung Self-rating Depression Scale (SDS);
Beck Depression Inventory (BDI);
Quick Self-Assessment Questionnaire for Depression Symptoms (QIDS-SR).
Among them, the item of PHQ-9 is consistent with the item of symptoms of the diagnostic criteria for depression in DSM-5.
Clinical He Rating Scale
For doctors, there are Hamilton Depression Scale (HAMD) and Montgomery Depression Scale (MADRS), which can comprehensively and accurately evaluate the depression symptoms of patients, and can also be mutually verified with the patient self-rating scale.
Other evaluation tools
Including suicide risk assessment, manic transformation risk assessment, quality of life and social function assessment, drug treatment side effects scale, Arizona sexual experience scale (ASEX), drug compliance rating scale (MARS), etc.
These scales can assist doctors in a comprehensive assessment of the patient's risk of depression, whether it is accompanied by mania, the impact of the disease on social function, the side effects of drugs, and compliance.
Differential diagnosis
Depression needs to be differentiated from secondary mood disorders, schizophrenia and other diseases.
Depression related to physical illness
Many physical diseases, such as cardiovascular diseases, respiratory diseases, etc., may be the direct cause, inducement, or accompanying depressive disorder.
During the diagnosis, the relevant medical history should be asked in detail and a comprehensive examination should be carried out to clarify the relationship between the two diseases, so as to provide active intervention and treatment, and do not care about one or the other.
dementia
Depressive disorder in elderly patients is often accompanied by obvious changes in cognitive function, and its performance is similar to dementia, which is called pseudodementia.
Different from the slow onset of Alzheimer's disease, the onset of senile depressive disorder is more rapid, and patients have certain requirements for treatment and self-awareness. The characteristics of morning and night can also be distinguished from dementia.
When conducting psychological tests, patients with depression are often reluctant to answer questions, while patients with dementia will make up as much as possible.
After antidepressant treatment is given, the cognitive function of patients with depression will recover to a certain extent in a short time, but patients with dementia do not have this performance.
Schizophrenia
Depression is the primary symptom of low mood, psychotic symptoms are secondary, and schizophrenia is just the opposite;
The mental activities such as thinking, emotion, and volitional behavior of patients with depression are coordinated, while those with schizophrenia are not coordinated;
Depression is an intermittent course, and the intermittent period is basically normal, while most schizophrenia has a progressive course, and there are often residual mental symptoms or personality changes in the remission period.
Post-traumatic stress disorder (PTSD)
Patients with post-traumatic stress disorder often accompany depressive symptoms, but patients often experience severe, catastrophic, life-threatening traumatic events, such as earthquakes, abuse, rape, etc., followed by anxiety, pain or ease. Arousal-based emotional changes. Patients often have trauma-related nightmares, nightmares, etc., often re-experience the traumatic event, and also have recurring mandatory memories.
Bipolar depression
Bipolar depression refers to the occurrence of manic episodes and depressive episodes, and the main symptoms of this episode are depressive symptoms. Patients with depression have no history of manic episodes, and depressive symptoms are always the main clinical manifestations.
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