Confronting depression: Testing and choosing a therapist

Confirming depression:  When extra tests  might help Image: iStock Medical science is making good progress in unraveling the biological underpinnings of depression. Someday, these discoveries may lead to lab tests that can help identify or confirm depression and other mood disorders. Right now, doctors and therapists rely on the symptoms reported by their patients, along with clinical expertise and experience, to diagnose depression and determine a course of treatment.

Get your copy of Understanding Depression

Depression is more than a passing bout of sadness or dejection, or feeling down in the dumps. It can leave you feeling continuously burdened and can sap the joy out of once-pleasurable activities. Effective treatment can lighten your mood, strengthen your connections with loved ones, allow you to find satisfaction in interests and hobbies, and make you feel more like yourself again.

Sometimes, though, additional information can help distinguish depression from other problems. That's why your doctor might recommend any of the following tests:

• Psychological tests, during which you answer questions, respond to images, or perform tasks like sorting cards or drawing pictures. These tests can give your doctor a better sense of your coping mechanisms, your temperament, or your ability to organize and plan.
• Tests that look at the brain, such as an EEG or MRI, which can help identify causes of dementia or some rare causes of depression. Both tests are painless. During an EEG, electrodes taped to your scalp pick up electrical signals. An MRI uses magnets, a radio wave transmitter, and a computer to make a detailed scan of your brain.
• Tests for other causes of depression, such as a blood test to check thyroid function.

Doctors generally order such tests only when they note a potential health problem during a physical exam or medical history.

For more information on the possible causes of depression and ways your doctor will work with you on a diagnosis, buy Understanding Depression, a Special Health Report from Harvard Medical School.

10 questions to ask when 

choosing a therapist

Image: iStock

Whether you get a recommendation for a therapist from your primary care doctor, a friend, or your insurance company, finding out about his or her background and training can help you feel comfortable with your choice. Here are some questions to ask before settling on a therapist:

1. What's your training (i.e., what certification or degrees do you hold)?
2. How long have you worked in this field?
3. What kinds of treatment or therapy do you think might help me?
4. What are the advantages and disadvantages of different approaches to treatment, including medications?
5. How does the type of treatment you offer work?
6. What are the chances that treatment will succeed?
7. How soon should I start feeling better?
8. How will we assess my progress?
9. What should I do if I don't feel better?
10. How much will treatment cost?

It's hard for a therapist to give precise answers to some of these questions, because no single therapist or type of treatment is best for everyone. But there are some general responses you should be looking for: The therapist should easily be able to describe his or her formal training and certification, for example. And while there's a tendency for mental health professionals to offer only the particular type of psychotherapy that they do best, it's a good sign if the person can describe the merits and drawbacks of different types of treatment, including ones he or she doesn't do.

It's also a good idea to ask your therapist to periodically check in with you about your progress. If you don't feel there's been improvement after several months, consider getting a second opinion.

Understanding Depression, a Special Health Report from Harvard Medical School, contains additional advice and recommendations for the diagnosis and treatment of depression. Purchase it here.