3 Minute Depression Test

Depression (also called major depressive disorder) presents with symptoms that range from mild to severe. Feelings of sadness, difficulty sleeping or sleeping too much, feeling worthless or guilty, loss of energy or increased fatigue, and a loss of interest or pleasure in activities once enjoyed are common. Children and adolescents who are depressed may come across as irritable rather than sad. A health care professional looks for symptoms that are interfering with the person’s relationships and with their work and that represent a change in the person’s previous level of functioning.¹ To receive a diagnosis of depression, the person must have five depression symptoms every day, and nearly all day, for at least two weeks.²

Primary care providers often diagnose depression. They may refer an individual to a mental health professional such as a psychiatrist or psychologist for treatment. Typically, says Steven Hollon, PhD, of Brentwood, Tennessee, a professor of psychology at Vanderbilt University, the provider uses the Diagnostic and Statistical Manual of Mental Disorders (DSM) to make a diagnosis.³ “They go through the criteria in the DSM to see how many criteria the person meets,” Hollon says.

Around 17.3 million U.S. adults have had at least one major depressive episode.² Some 20% of women and between 10 and 12% of men will experience depression at least once in their life, says Hollon. “Depression is relatively rare during childhood and comparably distributed across the genders,” he adds. “The rates just explode during adolescence and that is when gender disparities first emerge.” And, he adds, “Half of all the folks who are going to be diagnosed with major depression at some point will have at least one episode during adolescence.”

It can take weeks after depression begins before it is diagnosed. This is partly because people may be resistant to ask for help, says Rudy Nydegger, PhD, Professor Emeritus of Psychology and Management at Union College in Schenectady, New York, and chief in the Division of Psychology at Ellis Hospital, also in Schenectady. When a primary care doctor is looking into whether a person is depressed, they may initially think the symptoms could be caused by a physical illness, he explains. “Often, a primary care doctor may be looking at the person’s medications or whether something is going on physiologically,” says. “They are trying to rule out medical causes as the reason for the symptoms, which is appropriate, but then it can take longer to get a diagnosis.”

“Self-diagnosis is not helpful,” says Nydegger. “Instead of going online and researching the University of Google, ask your doctor.”

Adult women have a higher rate of depression at any given point in time (8.7%) as compared to adult men (5.3%). The age group that has the most adults who have had a major depressive episode is the 18 to 25 age group.² Children and teenagers get depressed, too, but it can be tricky to diagnose, Nydegger says. “We know that between 2 and 6% of children experience depression,” he says. “About 14% of teenagers age 12 to 17 will experience one episode of major depression. And about 9% of teenagers report a major depressive episode in a given year.”

Genetic factors do play a role in depression, but so do biological, environmental, and psychological factors.² Unipolar depression (depression only) is not that likely to be inherited, says Hollon. Bipolar disorder (which is marked by one or more manic or hypomanic episodes in addition to depression) is more likely to be inherited, he says.
While depression does tend to run in families, just because a family member has depression does not mean you are going to get it, Nydegger says. “It is not a simple gene thing,” he says. “And the important thing is not so much why a person has depression but what are we going to do to help them.”

“The number one cause of depression is the tough stuff, the major life events that go wrong,” Hollon says. Depression can occur when people experience adverse life events such as the death of someone close, the loss of a job, or some type of psychological trauma. Depression can lead to more stress and dysfunction, which can worsen the depression itself. There also is a connection between depression and physical health. For instance, cardiovascular disease can lead to depression (and vice versa).^4,5 Thankfully, there are effective treatments for depression. “We know that depression is a very treatable condition and that over 80 percent of people who receive appropriate treatment for their depression will improve significantly,” Nydegger says. “Unfortunately, the large majority of people with depression never get appropriate treatment.”