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
If patient acknowledges any depression, always inquire about suicidality.
- no energy
- no interests
- no libido
- poor concentration
- desire to just stay in bed in AM
- urge to cry
- low self esteem
- thoughts of death
- suicidal ideation
BEWARE — vagueness in explaining when presenting symptoms began, and what led them to seek care specifically today.
Imminently suicidal persons may not appear depressed
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.