Depression

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.

Advertisements