12.2 How to assess a person with depression
For a variety of reasons it may sometimes be difficult to assess a person with depression. The person may not know that they are depressed and may therefore be unlikely to tell you about their low mood. Instead they will often complain about physical symptoms, such as headache and back pain. They may not feel like talking and you may feel pushed away by them. Some patients with depression are easily annoyed or irritable and you may find it difficult to talk to them. Finally, they may be feeling that nothing is going to help them and may think it is pointless to talk about their problems.
These are only examples of the potential barriers for assessing depression. Whenever you suspect that someone might have depression, ask directly about their mood. A person is very unlikely to be upset if you ask them directly if they have been feeling low or depressed.
We have been talking about some of the symptoms a person with depression may have. In Study Session 10 you have learned about how to ask someone general screening questions about their mental health. Now can you stop and think what questions you would ask a person who may have depression?
When you see a person who you think may have depression, just talk to the person in a natural way, listening to their problems and difficulties. This will give you the opportunity to understand the kinds of problems the person may be having as well as to explore their emotions. The questions you ask and the emphasis are likely to vary from person to person, but there are general and specific questions that you can use to screen for depression. Some simple questions that you can use are:
- Have you been feeling sad or irritable?
- Have you given up doing things that you normally like to do?
- Since you started to feel sad or low, have you been feeling more tired than usual?
- Have you been sleeping normally or is there a problem with your sleep?
- Since you began to have a sad mood, has your appetite changed? Have you lost or gained weight recently?
- Have you been able to focus on things as well as you used to?
- Since you began feeling low, have you been feeling guilty or regretful about things that you have done or you have not done?
- How do you see the future?
- Are there times when you feel fed up and wish you were dead?