How to Get Screened for Depression

Major depressive disorder affects 17 percent of people in America. While some depression signs are easier to spot than others, there isn’t a way to truly diagnose the condition without concrete confirmation from a trained provider, such as a primary care physician or psychologist. 

Because so many adults, children and pregnant women will experience depression during their lifetime, it’s important to have screenings available for earlier diagnosis. This blog will highlight some of the more common screenings that can help you stay on top of your mental health.

Who may need a depression screening?

Any teenager or adult (including pregnant women or women who just delivered a baby) over the age of 12 should be screened for depression. People who display early symptoms of depression, such as persistent sadness or a loss of interest in otherwise enjoyable activities, should also receive a screening.

It’s important to remember a screening is different from a diagnosis. Screening tests are helpful in deciding if you need further assistance from a health care provider. For example, a high score on a screening test may prompt your primary care physician to refer you to a psychologist. However, screening tests shouldn’t take the place of a diagnosis.

Depression criteria

By definition, a clinical diagnosis of major depression requires you to have persistent (at least two weeks) feelings of sadness and changes in interests or activities. Additionally, five of these symptoms must be present:

• Weight loss or weight gain
• Difficulty sleeping
• Fatigue
• Feeling guilty or hopeless
• Lack of concentration that becomes problematic in day-to-day life
• Suicidal ideations
• Delayed movements

Doctors and other mental health providers use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) to diagnose depression. The manual is a comprehensive guide to help providers diagnose nearly 200 mental health conditions.

Types of depression screening tests

There are several types of screening tests that can alert health care providers of a patient being in a depressive state. Most of the screenings are self-tests in which you fill out an online document or paper questionnaire that is then sent to your provider for further evaluation.

Patient Health Questionnaire-9 (PHQ-9)

This nine-item questionnaire is typically the first screening given to patients by primary care providers. Each question requires a score of 0 to 3, with 0 indicating you haven’t experienced those feelings to 3 indicating you experience those feelings each day. PHQ-9 is used to screen and monitor depression symptoms. 

While brief, the questions involve several tell-tale signs of depression, including sadness, low energy, poor concentration, poor appetite and suicidal ideations. For example, the first question asks if you’ve experienced little interest or pleasure in doing things – a 0 indicates not at all and 3 indicates you experience no pleasure every day. A combined score of 10 to 14 indicates mild depression, 15 to 19 indicates a mild to moderate form of major depression and anything above 20 represents severe depression.

Beck depression inventory

Outside of PHQ-9, this 21-item screening test is one of the most common types of screenings used by doctors and mental health providers. Items cover topics such as sleep, appetite, interest in activities, feelings of failure, satisfaction in life and sadness. Responses are scored from 0 to 3, with 0 indicating no impact and 3 a sign of interfering with everyday activities. For example, one question asks about self-worth. Responding with a 0 indicates no disappointment in yourself, while a 3 indicates you hate yourself.

Center for Epidemiologic Studies Depression Scale (CES-D)

This 20-item screening test measures how often you have experienced depression symptoms during the past week. Each response is scored on a scale from 0 to 3, with 0 indicating no symptoms and 3 indicating recurring symptoms. For example, one item asks if you’ve felt sad during the past week. A score of 0 indicates rarely, while a score of 3 indicates you’ve felt sad most days of the week. In general, the higher the score, the more depressed a person may be.

EQ-5D

This screening test measures your quality of life using five subtopics – mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each section has five answers to choose from. For the anxiety/depression section, responses range from “I am not anxious or depressed” to “I am extremely anxious or depressed.”

Hamilton Depression Rating Scale (HAM-D)

This screening test contains 17 items that are measured either on 5-point or 3-point scales. The questions inquire about various aspects of your life during the past week. The items range from mood and insomnia to thoughts of suicide and how you feel performing work and other activities. A score below 10 indicates the absence of depression. A score between 10 and 13 can indicate mild depressive feelings, while 13 to 17 is moderate depression. Any score over 17 indicates severe depression.

Montgomery-Åsberg Depression Rating Scale (MADRS)

This 10-item screening measures depression in adults by using a series of questions along with a 7-point scale – each item is rated on a scale from 0 to 6, with 0 being normal or no changes noticed to 6 being the most severe feelings or symptoms For example, one of the items involves your appetite – answering no change in appetite would score a 0, while needing persuasion to eat would score a 6.

Social Problem-Solving Inventory-Revised (SPSI-RTM)

This screening test uses a series of questions (52 on the longer form and 25 on the shorter form) to gauge how well you can solve problems. The ability to problem solve has a direct link to depression. In fact, problem solving therapy is often used as a treatment for depression. 

Edinburgh Postnatal Depression Scale (EPDS)

Postpartum depression affects up to 1 in 7 women. This 10-question screening is given to pregnant mothers or mothers who have recently delivered their baby. Mothers are asked to answer the questions with how they’ve felt during the past seven days. There are four possible answers to check for each question, with each response receiving a score of 0, 1, 2 or 3. Thirty is the maximum score. Anything above a score of 13 indicates you may have some sort of depression. Sometimes, pediatrician’s will have you fill this out at your child’s well visits to ensure you’re not suffering from postpartum depression.

Why screen for depression?

As much stigma as depression and other mental health conditions have, the reality is mental illness is treatable, especially when found during the early stages.

As with any other illness, identifying depression can help prevent it from progressing into something more severe. Often, the first step in receiving help is acknowledging there is an initial problem.

Getting ahead of depressive thoughts can also lessen the chance it evolves into something more serious, such as suicide or substance abuse.

Think of depression screening as a mammogram or colonoscopy. These screenings alone won’t prevent breast cancer or colon cancer from mutating and causing harm, but early detection and treatment through routine screenings can drastically increase cancer survival rates.

Contact your primary care physician for more information on mental health screenings. They can point you in the direction of a screening that fits your needs and, if applicable, refer you to a mental health provider.