Skip to main content

"How Do I Know If I Have Depression?" The Role of Self-Assessment

What is Self Assessment?

Unlike other fields of medicine where illnesses can be diagnosed using laboratory tests or imaging techniques, psychiatry heavily relies on an individual’s account of their current and past symptoms. This is also true for depression. However, recounting one’s depressive symptoms without using an objective self-assessment tool is fraught with inaccuracies. People overemphasize symptoms that need urgent attention and miss some, especially if they are unaware of the full spectrum of depressive symptoms.

What are the Available Tools for Self-Assessment?

The internet is flooded with the so-called "depression tests" with questionable validity. The following self-assessment tools have been extensively used in research and/or clinical settings and can be downloaded for no charge from the internet. 

Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16): This is a 16-item self-rating scale used for screening depression or assessing its severity (Lamoureux et al., 2010; Rush et al., 2003). The scale comprises of domains of depression as covered in DSM-IV and has been validated for use in trials on depression. QIDS-SR16, along with its scoring instruction, is available online (www.ids-qids.org/).The total score ranges from 0-27 and if you score above 13 or 14, the chances of you being correctly identified as having depression is above 80% (Lamoureux et al., 2010). If you have been diagnosed with depression, then you can assess the severity of depression using the following guidelines: 0-5 (no depression), 6-10 (mild depression), 11-15 (moderate depression), 16-20 (severe depression), and ≥21 (very severe depression).


The Patient Health Questionniare-9 (PHQ-9): The PHQ-9 is a self-reporting scale, which is extensively used in primary care and other medical settings for screening depression. It has nine items which parallel the DSM-IV criteria for major depressive disorder with a total score ranging from 0-27 (Kroenke al., 2001). A copy of the scale can be downloaded from a website (http://www.phqscreeners.com/). On this scale, the cut-off scores of 5, 10, and 15 represent mild, moderate, and severe depressive symptoms, respectively (Kroenke et al., 2010). If you score 10 or higher on PHQ-9, then you have an above 82% chance of being correctly identified as having clinical depression (Haddad et al., 2013).

If you screen above the cut-off score for depression in one of the above rating scales, it is prudent to consult your primary care provider. They will either assess you in depth for depression or refer you to a mental health provider to do the same. Once diagnosed with depression, you can continue to use these self-assessment tools to monitor the progress of your symptoms and also the impact of treatment as described next.


What are the Advantages of Self-Assessment?


  • Self-assessment tools provide you with an objective measure on whether or not you have depression.
  • Once diagnosed with depression, periodic self-assessments help you monitor your progress with treatment and change course if needed.  
  • Sharing information from the self-assessment tools with your provider ensures that you don’t forget to report any important symptoms. 
  • Repeated self-assessments broaden your understanding of depression and help you recognize early symptoms in case of a relapse or recurrence. 
  • Self-assessments, if tracked along with interventions, will help you figure out the kind of interventions that have worked for particular symptoms and to put them to use if these symptoms return.

To learn more about evidence-based self-management techniques that are proven to work for depression, check out Dr. Duggal's Author Page.



HARPREET S. DUGGAL, MD, FAPA

REFERENCES

Haddad, M., Walters, P., Phillips, R., Tsakok, J., Williams, P., Mann, A., & Tylee, A. (2013). Detecting depression in patients with coronary heart disease: a diagnostic evaluation of the PHQ-9 and HADS-D in primary care, findings from the UPBEAT-UK study. PLoS One, 8(10), doi: 10.1371/journal.pone.0078493.  

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606-613.

Kroenke, K., Spitzer, R. L., Williams, J. B., & Löwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptoms scale: a systematic review. General Hospital Psychiatry, 32(4), 349-359.

Lamoureux, B. E., Linardatos, E., Fresco, D. M., Bartko, D., Logue, E., & Milo, L. (2010). Using the QIDS-SR16 to identify major depressive disorder in primary care medical patients. Behavior Therapy, 41, 423-431. 

Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B., Klein, D. N., Markowitz, J. C., Ninan, P. T., Kornstein, S., Manber, R., Thase, M. E., Kocsis, J. H., & Keller, M. B. (2003). The 16-item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biological Psychiatry, 54, 573-583.

Popular posts from this blog

Procrastination in Depression: The Motivation Myth

Procrastination is putting off things for another day, or doing things which are not productive as an excuse of not doing what is important. Dr. Wayne Dyer (1995) in his book, Your Erroneous Zones, provides the rationale behind procrastination as a thought process which is something like this: “I know I must do that, but I am really afraid that I might not do it well, or I won’t like it. So, I will tell myself that I will do it in the future, then I don’t have to admit to myself that I am not going to do it. And it is easier to accept myself this way.” This temporary avoidance gives you a quick relief from the anxiety associated with a task, which then reinforces this behavior. We all have procrastinated at one time or the other, but in depression, procrastination becomes more complex due to the self-defeating attitudes of perfectionism (“I can do things only if I can do them perfectly”), hopelessness (“My low motivation and low energy levels are never going get better”), and fear of …

When Feeling Depressed, Don’t Defend Your Vulnerabilities with Anger

Anger, irritability, and frustration may not be the core symptoms of major depression in adults, but almost 50% of people with major depression experience these symptoms (Fava et al., 2010; Judd et al., 2013). In addition, irritability may be the main presentation of mood in children and adolescents with depression. Having irritability and anger while being depressed is a double whammy. Overt irritability and anger during an episode of major depression is associated with greater severity of depression, longer duration of the episode of depression, poorer impulse control, a more chronic and severe long-term course of depression, higher rates of lifetime substance use and anxiety disorder, and greater psychosocial impairment (Judd et al., 2013).
When feeling depressed, you may be masking your more vulnerable feelings of hurt, guilt, shame, grief, or fear with anger or irritability. Depression causes the emotions that make you feel more vulnerable not come to the surface as you are uncert…