Physical Examination - Depression

Your primary-care doctor is an excellent person to see first if you are depressed. Your doctor can do an initial evaluation of depression and maybe even get you started with some basic advice or an antidepressant. Your doctor also can provide a referral to a mental-health professional.

Tell your doctor about your physical symptoms, as well as any symptoms of depression. He or she will probably ask the following:

How severe are your symptoms?
When, where and how frequently do they occur?
What brings the symptoms on?
What relieves the symptoms?

Your doctor will want to know how long your symptoms have lasted. For example, in dysthymia, symptoms can last for years, although they are less severe than the symptoms of major depression. Some people with dysthymia become so used to feeling down that they do not regard it as a problem that requires treatment. Your doctor should be able to determine whether your symptoms add up to a problem worth evaluating further.

Tell your doctor — if he or she doesn’t already know — about any medical illnesses you have or have had, what the treatment has been and what drugs you take. Depression may be caused or magnified by a medical problem or drug treatment. Talk about your family's history, because some illnesses run in families.

Sometimes it helps to write down what you want to say and bring it with you to your appointment with your doctor.

Here are some examples of what your doctor may do during your exam:

Examine your nervous system because psychiatric disorders and neurological disorders can overlap. Your doctor may ask if you have muscle weakness or problems with sensation or walking. Many parts of the exam test the functioning of your nervous system, including tests of movement, muscle strength and reflexes (for example, tapping your knee with a hammer).

Examine your neck to feel if your thyroid is enlarged because thyroid disorders can cause mood problems.

Listen to your heart and check your circulation by examining pulses in your arms and legs and seeing if you have any swelling in your feet because underlying heart problems can influence your mood.

Do a rectal exam to check for gastrointestinal bleeding because anemia can drain your energy.

In a few cases, finding and treating a physical problem eliminates depression. Even if a physical problem is not the cause of your depression, it is always a good idea to stay on top of your general health, because the body needs to function well for the brain to function well.