How To Get Diagnosed With Depression And Anxiety

If you think you might have clinical depression, you may not know what to do or where to begin to get help, especially if you've never experienced this before. First, it's important to recognize the symptoms that may indicate depression so you know what to discuss with your doctor.

Symptoms of Depression

Clinical depression, also called major depression, can have a range of ongoing symptoms. Some of the most common symptoms include:

Feelings of sadness, hopelessness, or guilt
Losing interest in activities you once enjoyed
Feeling tired or restless
Isolation
Difficulty sleeping or sleeping too much
Weight gain or loss

Rule Out Other Conditions

If you identify with the symptoms of depression, your next step should be a visit to your family doctor or general practitioner for a thorough exam and screening. Your provider will ask you about your health history and risk factors and may use written questionnaires to assess your symptoms.

Your family doctor or general practitioner will also want to rule out several medical conditions that can contribute to symptoms of depression, such as vitamin and mineral deficiencies, female hormonal changes, and thyroid conditions. In addition, several medications may have depressive symptoms as a side effect.

If your general practitioner doesn't find any of these factors as a cause of your depression, they may prescribe an antidepressant or refer you to a mental health professional, such as a psychiatrist, psychologist, or counselor.

In 2017, an estimated 17.3 million adults in the United States experienced at least one episode of severe depression, or 7.1% of all adults. For adolescents between the ages of 12 and 17 years old, the percentage is even higher, with an estimated 3.2 million adolescents (13.3%) in the U.S. experiencing at least one major depressive episode in a year.

Differences Among Doctors and Therapists

There are different medical and mental health professionals who can help treat your depression and get you on the path to feeling better. Learn the differences between them to inform your choices about which one might be best for you.

General practitioner (GP): Also known as an internal medicine physician or family physician, this is a medical doctor (MD) who has completed four years of medical school followed by a residency and sometimes a fellowship. General practitioners and family doctors screen for depression and may prescribe antidepressants, but may also provide a referral for a psychiatrist, psychologist, or counselor.
Psychiatrist: A psychiatrist is also a medical doctor (MD) who is trained to assess, diagnose, and treat mental health disorders like depression. They are physicians who earned an undergraduate degree, graduated from medical school, and completed a residency in psychiatric care. Psychiatrists can prescribe medications such as antidepressants. Psychiatrists do not always offer counseling or psychotherapy services but will often give referrals to therapists for treatment if they don't.
Psychologist: A clinical psychologist provides therapy sessions for individuals or groups. They have completed a five-year doctoral program in psychology earning a PhD, or alternatively, a PsyD, which is less research-focused and places more emphasis on the clinical treatment of mental health conditions. In most states, psychologists do not have the ability to prescribe medication.

Counselor: A licensed mental health counselor (LMHC) usually has two to three years of graduate training in counseling. This may include a focus on school counseling, community counseling, marriage and family counseling, or substance abuse counseling. Many states require counselors to be licensed by the National Board for Certified Counselors (NBCC). Counselors are unable to provide prescription medication.
Social worker: A licensed clinical social worker (LCSW) completes about two years of graduate training in therapy, followed by an internship and supervised experience in the field. They do not prescribe medication.
Psychiatric nurse: The psychiatric-mental health nurse holds at least a master's degree in psychiatric-mental health nursing, and can assess and diagnose disorders. Advanced psychiatric nurses known as clinical nurse specialists or nurse practitioners (NPs) work as clinical nurses in hospital settings, private clinics, and other treatment centers to offer psychotherapy, and in some states, prescribe medications.

Why a Mental Health Professional Is Best

It's very important—especially if this is your first time seeking treatment for depression—that you obtain a referral to a psychiatrist or other mental health professional if your general practitioner suspects depression.

Though your family doctor or general practitioner may offer to prescribe you an antidepressant, they are not always the best-qualified doctor to treat depression. They do not possess the training to offer you psychotherapy nor are they experienced in the nuances of prescribing psychotropic medications the way that a psychiatrist is.

Psychiatry is a blend of art and science. Treating depression is not quite as simple as giving someone a prescription for Zoloft (sertraline) or Prozac (fluoxetine) and sending them on their way. Some individuals will need several trials of different medications to find one that best relieves their symptoms with the least amount of side effects.

Some people will need more than one medication to counteract side effects or to boost positive effects. Most will likely benefit from adding psychotherapy to the mix. Discussing options with your psychiatrist will determine the best path.

Depression Discussion Guide

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Besides the medication specifics, you may have a completely different mental health condition and not depression. Bipolar disorder is one such disorder that may be initially misdiagnosed as depression but requires a very different course of treatment.

Other possibilities are attention-deficit/hyperactivity disorder (ADHD) or an anxiety disorder, either of which could be manifesting as depression because it hasn't been treated.

Psychiatrists and other mental health professionals are used to seeing a variety of mental health diagnoses and have more experience than a family doctor or general practitioner in teasing out what's behind your symptoms.

General Practitioner (MD)

Can diagnose depression and medical conditions causing or contributing to it
Can prescribe medication for depression
Cannot provide psychotherapy

Psychiatrist (MD)

Can diagnose specific mental health conditions
Psychiatrist can prescribe and fine-tune antidepressant medications
Can provide psychotherapy

Consider Seeing a Psychiatrist First

There's a tendency for some new patients to visit a counselor or psychologist for their initial mental health evaluation rather than a psychiatrist. This can be beneficial for many people, especially if your case is not severe, but for others, it's often not enough.

Only psychiatrists are also medical doctors, which means that they are able to prescribe medications.

If your depression stems from a chemical imbalance, talk therapy will not be sufficient to treat you. It's best to make your initial visit to a psychiatrist, who can both prescribe medications and offer you psychotherapy if it's needed. This two-pronged approach of medication and talk therapy is often the most beneficial to patients.

Psychotherapy is a broad term for a variety of different verbal and psychological techniques that are employed to help an individual work through their mental health condition or source of underlying stress. These techniques include but are not limited to psychoanalytic therapy or psychodynamic psychotherapy, behavior therapy, cognitive therapy, and cognitive behavioral therapy (CBT). Oftentimes, other mental health professionals in the field such as counselors and social workers will draw from psychotherapeutic techniques and use them with their clients.

While your psychiatrist is qualified to offer you psychotherapy services, don't be surprised if they refer you to a clinical psychologist, therapist, or licensed mental health counselor while they concentrate on fine-tuning your medication.

There is some debate within the psychiatric community as to whether the role of the psychiatrist as a talk therapist has become outdated as we learn more about the biological basis of depression and mental illness.

Some professionals argue that therapy can be left to the psychologists while the psychiatrist concentrates on the complexities of the patient's medical care. However, psychotherapy is a part of psychiatrists' training and they are fully qualified to offer it to patients if they choose.

The Path to Healing

The most important thing to remember about seeking depression treatment is simply to speak up and ask for help. Depression is not a sign of weakness or laziness, it's a sign that something is out of balance. Thankfully, with proper treatment, you can feel well again.

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U.S. Department of Health and Human Services. National Institute of Mental Health. Major depression. Updated February 2019.
American Psychiatric Association. What is psychiatry?
American Psychiatric Nurses Association. Psychiatric-mental health nurses.
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