The first step to getting appropriate treatment is a complete evaluation to determine whether an individual has a depressive disorder, and if so what type he or she has.  Certain medications as well as some medical conditions can produce symptoms of depression.

A diagnostic evaluation also will include a complete history of the individual's symptoms, including:

• When the symptoms started
• How long the symptoms have lasted
• How severe the symptoms are
• Whether the individual had ever had them before and, if so, whether he or she was treated and what treatment he or she received.

The therapist will also ask about alcohol and drug use and whether the individual has thoughts about death or suicide.  The individual's evaluation will also include questions about whether other family members have had a depressive illness and if treated, what treatments they may have received and which were effective.  A diagnostic evaluation will include a mental status examination to determine if the individual's speech or thought patterns or memory have been affected, as often happens in the case of a depressive or manic-depressive illness.  The choice of treatment for depression will depend on the outcome of the evaluation.  There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders.  Some people do well with psychotherapy, some with antidepressants.  Some do best with combined treatment:  medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems.  Depending on a individual's diagnosis and severity of symptoms, he or she may choose medication and/or treatment with one of the several forms of psychotherapy that have proven effective for depression.  Recent research reviews indicate that psychotherapy is at least as effective as anti-depressant medications for mild to severe depression, and is more effective in helping to avoid relapses.

A mental health professional should be consulted when an individual experiences any/all of the following circumstances:

• When pain or problems outweigh pleasures much of the time
• When symptoms are so severe and persistent that day-to-day functioning is impaired
• When stress seems so overwhelming that suicide is considered a viable option.