Getting screened or tested for physical illness and disease is a regular part of life: we all remember going to the doctor as kids and either getting the all clear or learning about something we need to take care of before it gets worse, and the same is true for mental health disorders – on National Depression Screening Day, it’s important for anyone at risk of depression, or anyone who thinks they may have clinical depression, to get a professional evaluation for major depressive disorder (MDD) administered by an experienced, qualified mental health provider.
Early detection of any disease or disorder is critical because, for any illness or disorder – mental or physical, the sooner a person with the disorder receives appropriate treatment for that disorder, the better the outcome.
That means screening for depression should be a regular part of any health care routine.
In this article, we’ll review why it’s important to receive regular depression screenings, how you know you need to get a screening, the current prevalence rates for depression among adolescents and young adults, the types of tests you might experience, and finally, what treatment might be like if you do receive a diagnosis for major depressive disorder (MDD).
We’ll start with the first question most people ask: why do I need to get tested for depression at all?
Screening and Testing for Depression: Why is it Important?
The non-profit organization that sponsors National Depression Screening Day, Mental Health America (MHA) identifies the following reasons everyone should get screened for depression, if and when they show any warning signs or risk factors:
- Major depressive disorder (MDD) is a serious medical condition.
- Untreated MDD can lead to suicidal behavior.*
- Being sad or low every day for two weeks or more is not just part of life.
- MDD can develop in anyone from any demographic group.
- MDD can develop alongside other medical conditions and complicate the treatment process.
- A depression test or screen is often the first step toward healing and recovery.
The reasons for getting screened for depression are the same as the reasons for getting screened for any physical illness. You want to know sooner, rather than later, if you need professional counseling or therapy, medication, or need to make lifestyle changes in to address your depression.
But how do you know if you need to get tested or screened for depression?
If you show any of the signs/symptoms or have risk factors for depression, then it’s important to get screened or tested or depression.
How Do I Know? Risk Factors and Warning Signs
Risk factors are elements in the life of an individual that increase the likelihood they’re develop depression. The risk factors for major depressive disorder (MDD) include:
- Family history of depression
- Traumatic experiences
- Adverse childhood experiences (ACEs)
- Presence of major physical illness
- Gut dysbiosis
- Stress
- Cognitive impairment
- Low self-esteem/low self-image
- Alcohol/substance use
We’ll reiterate that the presence of risk factors does not mean an individual will develop depression, but rather increase the likelihood of developing depression. When risk factors co-exist alongside the following signs and symptoms, arranging a professional screening for depression is essential:
- Frequent sadness/low mood
- Declining interest in preferred activities/hobbies
- Consistent/daily crying
- Consistent feelings of hopelessness
- Anger/irritability
- Persistent sense of worthlessness
- Constant fatigue/tiredness
- Withdrawal from family, friends, loved ones
- Boredom/restlessness
- Problems with memory, concentration, and decision-making
- Sleep problems
- Weight loss/gain
- Loss of interest in hygiene
- Suicidality*
- Uncharacteristic but common physical ailments that common remedies don’t help
*Never ignore talk of suicide. If you or someone you know is at imminent risk of harm, call 911 or get to a hospital emergency room now. If you or someone you know is in crisis, but not at imminent risk of harm, call 988, the National Suicide/Mental Health Help Line.*
Screening and Diagnosis: Two Steps Toward Healing
In most cases, receiving a diagnosis from MDD involves several steps. An initial screening is not necessarily a diagnosis: screenings often identify symptoms and indicate the need for full evaluation administered by a mental health professional. Only a qualified psychiatrist or clinical psychologist can diagnose a mental health disorder like depression.
When screening tools/questionnaires like those we describe below first appeared, the primary motive behind them was to help providers and patients in situations where mental health professionals were not readily available, or to help guide providers in making proper referrals to mental health professionals from care settings where mental health care was not the primary focus. Mental health experts agree that getting these tools into primary care settings has been a major step forward in public health and effectively broke the barrier of silence and stigma around mental health.
However, a positive score on a depression screen is not a diagnosis: it’s worth repeaing that only an experienced and qualified mental health professional can diagnose a mental health disorder, and a screening questionnaire is only one component in the diagnostic process.
With that said, let’s take a look at the latest information on the prevalence of depression among teens and young adults in the U.S.
Depression in the United States: Facts and Figures
Here are the latest figures on depression and depression treatment for people 12-25, as published in the 2023 National Survey on Drug Use and Health (2023 NSDUH):
Depression Among Young People 12-25: 2023
Major Depressive Episode (MDE):
- 12-17: 4.5 million
- Male: 1.2 million
- Female: 3.3 million
59.8 of adolescents ages 12-17 with MDE received professional treatment/support.
- 18-25: 5.9 million
- Male: 2.2 million
- Female: 3.7 million
58.8 of young adults ages 18-25 with MDE received professional treatment/support.
Major Depressive Episode (MDE) With Severe Impairment:
- 12-17: 3.3 million
- Male: 845,000
- Female: 2.5 million
63.6 of adolescents ages 12-17 with MDE With Severe Impairment received professional treatment/support.
- 18-25: 4.3 million
- Female: 1.6 million
- Male: 2.7 million
70.1 of young adults ages 18-25 with MDE With Severe Impairment received professional treatment/support.
We’ll do some quick math to make these figures more immediate:
- 1.8 million teens 12-17 with MDE did not get treatment
- 541,200 teens 12-17 with MDE with severe impairment did not get treatment
- 2.4 million young adults 18-25 with MDE did not get treatment
- 128,000 young adults 18-25 with MDE with severe impairment did not get treatment
Those figures add up to a surprising number: close to 5 million adolescents and young adults – 4,869,000 – did not get treatment for depression – and they all needed it. If they don’t get help, it’s unlikely their depression will improve. And that’s only among the people who were screened or tested for depression. We assume there are more young people out there who need professional support – and we want to reach them.
That’s what makes regular screening important.
Without an accurate diagnosis, it’s almost impossible to treat anyone for anything. That’s true for physical diseases, and it’s true for mental health disorders such as major depressive disorder (MDD).
Now let’s look at some of the most common depression tests in use by mental health professionals today.
The Multidimensional Depression Assessment Scale (MDAS)
The MDAS is designed to identify symptoms of depression in four key areas of life, called domains:
Domain One: Emotional.
Questions in this domain address the feelings common to depression, including sadness, hopelessness irritability and anger, and guilt/shame.
Domain Two: Cognitive.
Questions in this domain address the thoughts and patterns of thought common to depression, such as difficulty concentrating and making decisions, and low opinion of self/low self-concept.
Domian Three: Somatic.
Questions in this domain address physical factors common to depression, such as disrupted sleep, chronic pain, and changes in eating habits.
Domain Four: Interpersonal.
Questions in this domain address the components of depression that impair or disrupt relationships with other people, such as irritability, withdrawal, and feeling loved/feeling connected to friends and family.
Other standard depression tests take a different approach. For instance, the following depression tests are effective and can accurately diagnose/predict depression nine out of ten times, but they aren’t as thorough – and give clinicians less information – than the MDAS:
- Patient Health Questionnaire (PHQ-9): general depression test
- Children’s Depression Inventory (CDI/CDI-2): designed for children and adolescents ages 7-17
- Geriatric Depression Scale (GDS): designed for adults ages 60-65+
- The Beck Depression Inventory (BDI-II): general depression test
- The Hamilton Rating Scale for Depression (HAM-D): general depression test
- Montgomery-Asberg Depression Scale (MADRS): general depression test
- Edinburgh Postnatal Depression Scale (EPDS): for new mothers/parents
When an individual gets a full assessment for depression, one outcome may be a clinical diagnosis of depression. If the test or screen indicates depression and a qualified mental health professional confirms and makes and official diagnosis, the next thing that happens, in most cases, is a referral for care.
We’ll end this article with a brief overview of what treatment for depression entails.
How Do Mental Health Professionals Treat Depression?
Studies show that the best approach to treating depression in teens and young adults is with a comprehensive treatment model that addresses the biological, psychological, and social components of depression. A treatment plan for MDD may include:
- Individual therapy and/or psychiatry
- Group therapy
- Complementary therapies
- Medication, if needed
- Lifestyle changes
- Classes/educational workshops
Depending on the severity of the disorder, i.e. whether MDD is mild, moderate, or severe, an individual may receive a referral for a specific level of care:
- Mild depression often involves once a week, or once every other week, therapy, counseling or psychiatry. Medication may or may not be part of treatment.
- Moderate depression may involve once a week therapy/counseling, an intensive outpatient program (IOP), or a partial hospitalization program (PHP), and in most cases, medication.
- Severe depression may involve IOP, PHP, or inpatient residential treatment, and in most cases, medication.
Lifestyle changes, family involvement, and peer/social support are key components of treatment for depression of any severity, and both support and promote healing, growth, and recovery.
If you someone you know has risk factors for depression and shows signs and symptoms of depression – as listed above – we encourage you to arrange a full psychiatric evaluation. The consequences of untreated depression can be severe. However, it’s important to understand that treatment works, and the sooner a person diagnosed with MDD gets evidence-based treatment from a high-quality treatment center with skilled and qualified clinicians, the better the outcome.
