How is Depression Diagnosed?

According to some research, the majority of people with Parkinson’s disease (PD) will go undiagnosed or undertreated for depression. Therefore, getting a diagnosis is a critical first step toward effective treatment and recovery.  Depression is usually diagnosed by a primary care doctor, or a mental health professional, who will ask questions about certain signs and symptoms. The doctor will talk with the patient about mood changes, experiences and behaviors. Depression is commonly divided into major and minor depression with major depression being more severe. 

To be diagnosed with major depression, a person must experience one of the following symptoms most of the time over the previous two weeks:

  • Depressed mood 
  • Loss of interest or pleasure in activities once enjoyed

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

  • Changes in sleep or appetite
  • Decreased concentration or attention problems
  • 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 Parkinson's

  • Certain symptoms of depression overlap with symptoms of PD ---for example, sleep problems and feeling slowed down occur in both conditions.
  • 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 people with PD express less emotion due to the effect the disease has on the muscles of the face. This symptom, called facial masking, makes a person look as if they aren’t enjoying themselves.
  • Because people with Parkinson’s often do not recognize they have a mood problem or are unable to explain their symptoms, many do not see treatment.
  • For 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.

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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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