Does my patient have depression?
Does the patient have any of the following symptoms?
- Low Mood
- Concentration problems
- Memory problems
- Sleep disturbances (insomnia/excessive sleep)
- Unexplained weight changes
If Yes, rule out common medical causes:
Differential Diagnosis of Major Depressive Disorder
Has the patient experienced five (5) or more of the below symptoms for at least two consecutive weeks?
- Low mood/Depressed mood/Sad mood nearly everyday for most of the day?
- Diminished interest or pleasure in all, or almost all, activities nearly everyday for most of the day?
- Significant weight changes (gain or loss of >5% of body weight in one month) or appetite changes?
- Sleep problems (e.g., insomnia, hypersomnia)?
- Psychomotor agitation or retardation (usually observed by others)?
- Fatigue or loss of energy?
- Feelings of worthlessness or excessive guilt?
- Concentration problems or indecisiveness?
- Thoughts of death? Suicidal thoughts?
If Yes: Major Depressive Episode. Screen for/Rule out Mania and Hypomania (See Diagram “Rule Out Bipolar Disorder” Below)
If No: Screen for/Rule out Mania (See Diagram “Rule Out Bipolar Disorder” Below)
How to Rule out history of manic or hypomanic episodes:
If drug use was not present during the period of elevated/euphoric/irritable mood, did the patient have three (3) or more of the following additional symptoms?
- Inflated self esteem
- Decrease need for sleep (e.g. feels rested after only 3 hours of sleep)
- More talkative than usual or pressure to keep talking
- Flight of ideas or racing thoughts
- Increased goal-directed activities (socially, work related, school, sexual) or agitation
- Easily distracted
- High risk behaviors/activities (e.g., speeding, buying sprees, sexual indiscretions, foolish business investments)
NOTE: If Bipolar Disorder is diagnosed, avoid starting antidepressants.
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