In this video, Robert D. McMullen, MD of NYC, USA discusses ways to diagnose depression.
He is a provider with over 30 years practice as a psychiatric health professional. He specializes in psychopharmacology medications and transcranial magnetic stimulation (TMS).
After sharing his credentials — his educational background and where he did his residency — in a brief greeting and introduction, Robert D. McMullen dives right into his discussion on diagnosing a person who is clinically depressed. Immediately distinguishing depression from physical ailments, he explains there are no practical means or objective qualifiers in the form of physical testing for deciding if a person is experiencing an episode of depression.
Apart from probing questions which a psychiatrist may ask to get a sense of what a patient experiences from day-to-day, McMullen provides information on the use of brain scans and blood tests to diagnose depression. The pet scans he said would suggest if there is a depression in the brain and the blood test would check cortisol levels.
In the video, the doctor explains that although the word “depressed” gets used loosely to describe moments of sadness, depression is more than a feeling. Depression is inclusive of melancholia but diagnosed through the consideration of several other symptoms. The contributors of moderate to severe depression when grouped can take a prolonged sense of sadness and propel it up the ranks of psychopathology to the point of clinical depression.
Are you experiencing symptoms consistent with a person who is clinically depressed? Do you live in New York City? Call (212) 362-9635 and make an appointment at TMS Brain Care. Our treatment and therapy options can address those issues.
What are some known treatments for depression?
Unlike a person who has had an A1C test and has had a doctor say he or she has Type II diabetes, there is no soundly scientific methodology in the form of physical testing for measuring depression. It is far easier to get lab work done for anemia or hook a patient up to a sphygmomanometer for a blood pressure reading than it is to objectively measure the severity of the depression a person is experiencing.
There are some tests administrable which can offer some insight into a person’s condition. They can gauge if a major depressive disorder is present, but cost and accessibility cause a lack of practicality. Also, the quality of the results does not add much to how the psychiatrist will diagnose the condition. It would help doctors and patients if there were more comprehensive physical tests in place which could tell if an individual is clinically depressed versus having been unhappy for an extended length of time.
Brain scans can be used to show decreased brain activity which would be indicative that depression is a condition present in a person. Robert D. McMullen, MD of TMS Brain Care, NYC says that pet scans, unfortunately, are not accessible with ease or readily available. He says that the use of brain scans are primarily for research purposes, and regardless of a doctor’s ability and willingness to pay for their use, pet scans are hard to get through reservations.
An electroencephalogram (EEG) can look at a person’s brain for structural difficulties that could be the cause of mental dysfunction resulting in a mood disorder like depression. McMullen, however, feels that using an EEG will shed no more light on the severity of person’s mental condition than if a patient were to be open with a doctor about the symptoms he or she may be experiencing during a verbal assessment.
Dexamethasone Suppression Test
Doctors perform this test in one of two ways — as a “common” overnight method for low or high dose or over a “standard” three-day period. A patient receives the corticosteroid, dexamethasone, and after the relevant passage of time depending on the testing method, a doctor will draw blood to measure the cortisol level. Cortisol is a hormone secreted in a person’s body as a reaction to stress. Chronic elevations of cortisol in a body have linkage to people being clinically depressed during clinical studies.
Hopes for future diagnosis
Doctors and researchers hope that in coming years, there will be a physical test in place that can help health care providers pinpoint what kind of depression a person has and provide a way to predict what treatment would have the most efficacy. For transcranial magnetic stimulation (TMS), a test of that kind would be most advantageous. It could help an MD like Robert D. McMullen. He regularly performs TMS treatments on patients in New York City. To know which areas of the brain have received the most impact would provide analysis for which area would benefit the most from the magnetic pulses to the prefrontal cortex of the patient’s brain from the TMS.
With next to no side effects, TMS is offsetting the depressive states of those clinically depressed in as little as four consecutive weeks. For more information about TMS, call (212) 362-9635 to make an appointment in NY.
What are the considerations a psychiatrist needs to diagnose major depressive disorder?
In the USA, major depressive disorder affects the lives of 15 million adults in any given year. When diagnosing for depression, we make sure that our patients can accurately take stock of what they are experiencing. Going to the movies, grabbing a drink with friends, indulging in decadent chocolate desserts or forcing yourself to “snap out of it” would ordinarily work for a sudden depressed feeling or sadness.
However, clinical depression does not go away as quickly as average unhappiness because it is a syndrome. It is a composite of symptoms which when isolated gets remedied through simple measures but when grouped together requires advanced therapy.
A clinically depressed person may feel any combination of the following symptoms:
- Sleeping problems – you may be sleeping too little, too much or intermittingly throughout the night
- Concentration issues – you have difficulty reading sentences or paying attention to what someone is saying when he or she are speaking directly to you
- Energy deficiencies – you may experience increased fatigue or energy levels that are drastically low
- Lassitude – it may take you an enormous effort to do the simplest of tasks, like take out the trash or something important, like file your taxes
- Anxiety – you might ruminate on things, typically situations out of your immediate control or you are incessantly worried everything
- Excessive guilt – there’s a feeling of concern over decisions made in the past, or you wonder if you need to make better choices to handle present situations
- Low self-esteem – you may have an overwhelming feeling of inferiority and regularly blame yourself for being a failure
- Suicidal thoughts – you may have frequent ideations about wishing you were better off dead or that you do not want to wake up in the morning
Benefits of suicidal thoughts
When you make an appointment to speak to a psychiatrist, and go in for assessment, you can inform the therapist through rating scales of each of the symptoms above how the depression is manifesting in your daily life. Incidentally, suicidal thoughts are an excellent way of judging the severity of the depression. The more many the morbid views you have and the length of time you spend having those ideas, the worse your condition may be getting. When you find that you are spending less time thinking about death from day to day, it is a sign that your condition is improving.
The important thing for you do if you have if you have symptoms that could be consistent with clinical depression is to get a proper diagnosis. The staff at TMS Brain Care NYC USA can assess your condition and work with you to determine the best treatment and therapy for depression. If you are local to New York City, call (212) 362-9635 if you want to learn more about what it means to receive a clinically depressed diagnosis or find out more about transcranial magnetic stimulation.