Can a Neurologist Treat Depression?

Depression: diagnosis

The following criteria, among others, are decisive for a diagnosis:

  • At least two main symptoms (three for a severe episode) for at least two weeks (shorter if symptoms are severe or occur particularly quickly).
  • For determining the severity: In addition to the main symptoms, there are at least two additional symptoms for a mild episode, three to four for a moderate episode and more than four for a severe episode.
  • For a somatic syndrome Must have a mild or moderate depressive episode and four of the above characteristics must occur.

In the severe form, a distinction is also made between whether psychotic symptoms such as delusions or hallucinations are present. For more information on the various forms of depression and their characteristics, see Depression: Forms & Gradients. If the physical symptoms that occur in a depressive disorder (e.g. headache or nausea) are not correctly interpreted, this can make the diagnosis of depression more difficult or significantly delayed.

People with depression often suffer from additional illnesses (comorbidity). For example mental illnesses such as anxiety and panic disorders, substance abuse, eating disorders, somatoform disorders and personality disorders. But pain, dementia, diabetes mellitus, cancer and other chronic diseases also occur together with depression.

Diagnostic options

The conversation with the patient and the taking of the anamnesis (medical history including illnesses in the family) are important cornerstones of the diagnosis of depression. In the area of ​​mental illnesses there are various symptoms that are specifically queried. The physical, mental and social influences are always taken into account. At the first consultation with a doctor, only physical complaints (e.g. pain) or symptoms such as tiredness or listlessness are often mentioned. However, these can indicate depression. A physical examination is always necessary and includes one.

The examining doctor can also use laboratory tests (blood sampling) or radiological imaging (CT or MRI of the brain, ultrasound of the vessels supplying the brain, etc.) for diagnosis. Special interview questionnaires facilitate the diagnosis of depression, e.g. questionnaires for the diagnosis of depression according to DSM-IV (Diagnostic and Statistical Manual of Mental Disorders). In addition, the origin of the depression must be investigated.

The so-called "two-question test" offers a very simple, short, but targeted recording for orientation. These two questions are asked:

  • "Have you felt down a lot, sadly depressed, or hopeless in the past month?"
  • "In the last month, have you had significantly less pleasure and pleasure in things that you otherwise enjoy doing?"

If both questions are answered with "yes", further clarification is important in any case.