"I was the sort of person, like Tigger, you know, [who] bounded out of bed in the mornings and couldn't wait to face the day. I absolutely adored life. And all of a sudden I was thinking about how to end it. And I knew that was terribly wrong, but I didn't think in my mind 'I have an illness' — it's just not how you conceptualize depression. You say to yourself, 'Get on with it; what's wrong with you?' … I had been brought up in a world where you were totally self-reliant and you didn't give in to whims and moods. It was simply unacceptable."
- Kay Redfield Jamison - Psychiatrist, Researcher, Author

Unfortunately, depression is under-diagnosed and under-treated. There are three reasons for that.

  1. There are no definitive medical tests that can be performed and many family doctors fail to recognize depression in the patient.
  2. Most people who are depressed don't see themselves as having the symptoms of depression. Therefore, they don't do anything about it.
  3. Many depression sufferers lack the motivation and energy required to even see a doctor.

The first step to getting appropriate treatment for depression is a physical examination by a physician. Certain medications, as well as some medical conditions such as a viral infection, can cause the same symptoms as depression, and your doctor should rule out these possibilities through examination, interview, and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation should be done, by the physician or by referral to a psychiatrist or psychologist.

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A good diagnostic evaluation will include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective.

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Last, a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness.

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