If a doctor suspects clinical depression ?

Q.If a doctor suspects that some or all of a patients symptoms are caused by clinical depression what are the proper scientific/medical ways to rule in or rule out clinical depression? What are some incorrect ways?

A.Clinical depression is usually more of a diagnosis of elimination, at least at first. First is the symptom cluster (it is long and involved and I am assuming you know that since someone is entertaining the diagnosis. If you need it, I'll post it). Next do thyroid and adrenal tests to r/o that as a problem. Look at medications already on as some cardiac drugs, antihypertensives, sedative/hypnotics, antiseizure medications, antiparkinsons drugs and even some analgesics can be associated with depression-like symptoms. Neuro work up would be important. Parkinson's & Alzhemimers disease and some dementing illnesses can mimic. Temporal lobe epliespy can sometimes have depressive symptoms between seizures. Depression can be a follow on problem in strokes and some kinds of tumors. There are a number of OTHER mental disorders that can have a depression component and need to be addressed. Alcohol usage is a biggie. Adjustment disorders with depressed mood, etc. If clinical depression is a diagnosis of elimination then the real definition of clinical depression MUST be: "The condition of having any symptoms whose causes can't be determined by the tests your MD chooses to run." Daniel, I know from your other postings that you've had chronic health problems for a long time without being able to get a good diagnosis. If your doctor wants to try an antidepressant, don't assume he/she thinks depression is your diagnosis. Many drugs that are usually used as antidepressants have been found useful in treating a lot of other, apparently unrelated neurological problems, including sleep disorders and chronic pain among others. Modern SSRI drugs are generally quite safe compared to older antidepressants. If your doctor suggests seeing if one of these drugs can help control some of your symptoms, it seems like a reasonable thing to try. You really don't have anything to lose, since you can stop the drug if it doesn't work, and perhaps try a different one. If it does work, it doesn't mean that you are or were suffering from clinical depression, just that you've managed to find something that can help, possibly by a completely different method than it works to help depression.

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