How Do Mental Health Experts Diagnose Clinical Depression?

Clinical depression, also known as major depressive disorder (MDD), is included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and is recognized as a serous mood disorder. According to Johns Hopkins Medicine, “a mood disorder is a mental health class that health professionals use to broadly describe all types of depression and bipolar disorders.” Clinical depression is characterized by persistently depressed mood and/ or a loss of interest in previously enjoyed activities, impairing one’s ability to function in his or her daily life.

Diagnosis Process

Clinical depression is known as a differential diagnosis. A differential diagnosis implies that there are other possible diagnoses, and requires the diagnostician to differentiate between these possibilities to determine the actual diagnosis and appropriate treatment plan. To begin the diagnosis process, an individual must undergo a physical exam, including a complete medical history. Although there are currently no laboratory test or scans used to detect or diagnose major depressive disorder, some tests (e.g., blood tests) may be used in the diagnosis process to check for any other underlying conditions that may be causing symptoms. 

If no signs of physical illness are determined, the process continues with an assessment conducted by a mental health professional that specializes in diagnosing and treating mental illnesses (e.g., psychiatrist, psychologist, etc.). The mental health professional will ask in-depth questions about one’s reported symptoms (e.g., how long they last, how intense they are, etc.), how the symptoms interfere with one’s daily life, will make observations of one’s attitude and behavior, and may use psychological questionnaires to help determine a diagnosis. Mental health experts also rely on the diagnostic criteria provided in the DSM-5, which is outlined as follows:

1. An individual must be experiencing five or more of the following symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure:
   1. Depressed mood most of the day, nearly every day.
   2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
   3. Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day.
   4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
   5. Fatigue or loss of energy nearly every day.
   6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
   7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
   8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

These symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.

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