How is Depression Diagnosed?

Depression in PD is diagnosed by asking about certain signs and symptoms, the same as those commonly reported by depressed patients in general. Depression is commonly divided into major and minor depression with major depression being more severe.

To have major depression, a patient must have one of the following most of the time over the previous two weeks:

• Depressed mood 
• Loss of interest or pleasure

In addition, some of the following symptoms must be present:

• Changes in sleep or appetite 
• Decreased concentration or attention 
• Increased fatigue 
• Feeling slowed down or restless 
• Feeling worthless and guilty 
• Suicide ideas or a wish for death

Difficulties in Diagnosing Depression in Patients with PD

• Some of the same symptoms of depression can also occur in PD without depression--for example feeling tired and slowed down.
• Some experts think that depression in PD often involves frequent, shorter changes in mood versus a constant state of sadness on a daily basis.
• Many PD patients express less emotion due to the effect of the disease on the muscles of the face, and this may make them look like they don’t enjoy things.
• Some PD patients do not realize or admit they are depressed as they may have difficulty in recognizing emotions in themselves and other people.
• For all of these reasons it is helpful to ask a caregiver or a significant other if he or she has noticed any changes commonly reported in depression.

Medical content reviewed by: Nina Browner, MD—Medical Director of the NPF Center of Excellence at the University of North Carolina at Chapel Hill in North Carolina and by Fernando Pagan, MD—Medical Director of the NPF Center of Excellence at Georgetown University Hospital in Washington, D.C.

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