Depression screenings

Major depression is one of the most common mental health disorders in the United States.

There are different types of depression. The most common types are:

• Major depression, which causes persistent feelings of sadness, anger, and/or frustration. Major depression lasts for several weeks or longer.
• Persistent depressive disorder, which causes depressive symptoms that last two years or more.
• Postpartum depression. Many new mothers feel sad, but postpartum depression causes extreme sadness and anxiety after childbirth. It can make it hard for mothers to care for themselves and/or their babies.
• Seasonal affective disorder (SAD). This form of depression usually happens in winter when there is less sunlight. Most people with SAD feel better in the spring and summer.
• Psychotic depression occurs with psychosis, a more serious psychiatric disorder. Psychosis can cause people to lose touch with reality.
• Bipolar disorder. People with bipolar disorder have alternating episodes of mania (extreme highs or euphoria) and depression.

Who is at risk

Among general adult populations, prevalence rates vary by sex, age, race/ethnicity, education, marital status, geographic location, and employment status. Women, young and middle-aged adults, and nonwhite persons have higher rates of depression than their counterparts, as do persons who are undereducated, previously married, or unemployed. Other groups who are at increased risk of developing depression include persons with chronic illnesses (e.g., cancer or cardiovascular disease), other mental health disorders (including substance misuse), or a family history of psychiatric disorders.

Among older adults, risk factors for depression include disability and poor health status related to medical illness, complicated grief, chronic sleep disturbance, loneliness, and a history of depression.

Risk factors for depression during pregnancy and postpartum include poor self-esteem, child-care stress, prenatal anxiety, life stress, decreased social support, single/unpartnered relationship status, history of depression, difficult infant temperament, previous postpartum depression, lower socioeconomic status, and unintended pregnancy.

Symptoms

Women with perinatal depression exhibit significantly higher levels of hostility and disengagement from their babies than women without perinatal depression. Women with perinatal depression are also more likely to exhibit significantly lower levels of praising and playing with their child. Perinatal depression is linked to an increased risk of preterm birth, small for gestational age newborn, and low birth weight. Infants whose mothers have perinatal depression are at increased risk of early cessation of breastfeeding and have been shown to receive fewer vaccinations compared with infants whose mothers are without depressive symptoms. Perinatal depression can also affect a child’s cognition and emotional development. Children of mothers who had perinatal depression demonstrate more behavior problems, lower cognitive functioning, and increased risk of developing psychiatric disorders.

Signs of depression include:

• Thoughts about suicide
• Loss of interest or pleasure in daily living and/or other activities, such as hobbies, sports, or sex
• Anger, frustration, or irritability
• Trouble falling asleep and/or staying asleep or sleeping too much
• Fatigue and lack of energy
• Restlessness
• Trouble concentrating or making decisions
• Feelings of guilt or worthlessness
• Losing or gaining a lot of weight

If you are thinking about hurting yourself, call 911.

Suicide Prevention Resource Center

What you can do

• Minimize stress.
• Spend time with family and friends that make you feel good about yourself.
• Stay involved in your favorite activities.
• Avoid alcohol.
• Get plenty of exercise.

Preventive service at no cost

Why screening is important

Once identified, treatment is available for those with depression.

Depression affects individuals, families, businesses, and society.

People with major depression typically have functional impairments in their performance at school or work, as well as in their interactions with their families and peers. Depression can also negatively affect the developmental trajectories of affected youth. Major depressive disorder in children and adolescents is strongly associated with recurrent depression in adulthood, other mental disorders, and increased risk for suicidal ideation, suicide attempts, and suicide completion.

It is well established that depression during the postpartum period can lead to adverse effects on the mother and infant.

What the screening is

Many depression screening tools are available for your primary care physician to assess you. You may also be asked to fill out a questionnaire.

If you screen positive for depression, your doctor will conduct additional assessments that consider severity and other problems (e.g., anxiety, panic attacks, or substance misuse), alternate diagnoses, and medical conditions.

Treatment

Depression can be managed in the primary care or mental health counseling setting or collaboratively in both settings.

Treatment options for depression include medication, behavioral counseling, and collaborative care, some of which require coordination between your doctors.

Collaborative care is a multicomponent, healthcare system–level intervention that uses care managers to link primary care providers, patients, and mental health specialists.

Additional tips

• Get a pet.
• Get more sunlight.