Even if a telltale affect suggests an immediate diagnosis, go through the same H&P you would with anyone, because:
  • You gain credibility; and
  • Maybe mood is secondary — their whatever-other-kind-of headache/fatigue/pain/etc.  has made them depressed.

Symptoms of Depression

  • no energy
  • no interests
  • no libido
  • poor concentration
  • desire to just stay in bed in AM
  • insomnia
  • hypersomnia
  • anorexia
  • overeating
  • constipation
  •  sadness
  • urge to cry
  • hopelessness
  • low self esteem
  • thoughts of death
  • suicidal ideation
If patient acknowledges any depression, always inquire about suicidality.
  • Imminently suicidal persons may not appear depressed
BEWARE —  vagueness in explaining when presenting symptoms began, and what led them to seek care specifically today.
  • If patient’s history just doesn’t seem to make sense, explore possibilities like occult depression or suicidality (or domestic abuse, sexually transmitted disease, chest pain in denial, etc.).

See also our posting Depression.