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Miss F has a month's history of progressively worsening tiredness. Her symptoms started soon after she took up a new position at a local school. She is generally healthy.
Diagnosing depression is no easy task. Generally patients complain about other things, and their doctor needs to pick up that there is more to the visit than meets the eye.
Read: Is this depression?
Depression usually causes a conglomerate of symptoms. These include:
1. Feeling tired for most part of the day
2. Not gaining any pleasure or satisfaction from activities that the person previously enjoyed doing
3. Emotional lability: feeling close to tears; sensitive and finding it difficult to control emotions
4. Excessive sleep or no sleep, or changes in sleeping behaviour
5. Changes in appetite: either no appetite or excessive eating
6. Poor concentration
7. Decrease in libido
8. Social isolation: preferring to be on one's own, not wanting to socialise with friends
Part of diagnosing depression is also to exclude other organic causes of symptoms, like thyroid disease. A full an thorough physical examination is therefore vital.
Examples of other questions to ask Miss F:
1. Are there any acute stressors that might be causing her symptoms?
2. Is there a family history of psychiatric disease?
3. Does she hear voices or see things that aren't real?
4. Does she ever experience episodes of excessive energy or "highs"?
5. Does she ever consider suicide or have thoughts of ending her life?
Other important sideroom investigations:
1. Pregnancy tests
2. Hemoglobin and sugar testing
What else to look out for on examination:
- Signs of thyroid disease
Important blood tests to do:
- Thyroid functions, kidney functions, iron levels
Treating depression is not always straightforward and may require both pharmacological intervention (e.g. anti-depressants) and psychotherapy (sessions with a clinical psychologist).
NOTE: Health24's on-site GP Dr Owen Wiese reveals new cases on Thursdays. The answer is posted with the story on Mondays, or you can get it in our Daily Tip – sign up here.
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