Diagnosing depression can be difficult as it can manifest very differently in different people, and at different times. Diagnosis may be delayed because ‘symptoms’ are non-specific or masked by other health problems. Depression can often exist alongside other mental health problems, especially in young people, (also known as co-morbidity) which can also add to the difficulty of making a diagnosis.
Depression presents a range of physical and emotional ‘symptoms’ which need to be carefully explored to reach an accurate diagnosis. The process of diagnosis often entails a physical examination, filling in a depression symptom questionnaire and a careful exploration of symptoms, in the context of the person’s medical history. Sometimes depression is diagnosed after other possible conditions have been ruled out.
Frankie had MRI and EEG scans first to check there was nothing physically wrong with her.
Many young people we spoke with had been given a depression diagnosis. Here they talk about the process of getting a diagnosis and their feelings about it.
For quite a few people it had taken a long time to seek help or to feel able to talk to someone about their problems. The barrier to seeking help seemed high for many, and sometimes the pressures people felt from home, in their peer groups or unpleasant past experiences of the health care system made it more difficult. A couple of people had felt ‘defensive’ or been ‘in denial’ about their problems, and hence reluctant to reach out.
Saras mum got upset and angry about her wanting to see a psychiatrist so Sara decided not to…
Ruby says it was terrifying to tell her teacher about the bulimia because her past experience…
A couple of people had taken years to tell someone about how they were feeling, others had for a long time not been taken seriously by their doctor. Sometimes it was a parent or friend who noticed the change in behaviour or moods and encouraged them to seek help. Severe physical symptoms, like panic attacks or weight loss, had made a few people get help as they felt they could no longer ‘ignore’ the problems.
Severe panic attacks made Jack finally contact the local counselling service.
Ruby says it took absolutely everything to go wrong for her to seek professional help.
Some people felt that if they’d been diagnosed earlier, or at least someone had recognised depression, they might have been able to ‘hit it on the head’ perhaps with fewer repercussions. Instead, their low moods had escalated over years and become more frequent. During this time some also developed panic attacks or anxiety.
‘Just the teenage blues’
Initially, when seeing the doctor about their problems, many felt they weren’t taken seriously. A couple of people who went to their GP in their early teens were told they were ‘too young’ to have depression and were given no information or advice. One woman said the doctor put her moods down to ‘hormones’ and nothing was done until she went back a couple of years later.
At 13 Erika-Maye was told she was too young for the doctor to do anything about her depression.
Many noted that it was hard to diagnose teenagers with depression as teenage years can be turbulent time anyway, with physical and emotional changes and mood swings. One woman said adolescence is the ‘worst time’ to get depression because it’s so difficult to detect then. A couple of people themselves too had first thought their low moods were just a part of ‘difficult puberty’ or their parents thought they were just ‘mopey teenagers’.
Joanna says distinguishing depression in teenagers is really difficult because its not easy to…
Sarah’s parents put her problems down to just being ‘a teenage thing.
Several people felt diagnosing depression was questionable as it tended to be ‘fuzzy’, mental health was ‘unscientific’ and the boundaries between what is seen as depression and ‘normal’ was unclear.
Edward says that without any psychometric tests, psychiatry is still ‘a bit subjective…
Feelings about diagnosis
Most of the people who had been given a diagnosis felt the diagnosis had some positive outcomes. Many described getting a diagnosis as ‘a relief’. They felt it finally explained things and was a useful ‘label’ for the experiences some of them had had for years. One man found getting a diagnosis took a huge ‘pressure off’ his shoulders; a woman was relieved to hear a professional ‘say the word which had echoed’ in her head for ages.
Jo was relieved about the diagnosis but at the same time felt her experiences werent severe…
Craig describes feeling nervous before his appointment with the consultant but telling her, and…
Filling out a depression symptom questionnaire made Dan realise that things werent right.
People also felt that after depression diagnosis they were taken more seriously; because ‘something was actually wrong’, it made the experience of depression ‘more real’ and gave some a sense of validation that they were right and their experiences were not ‘normal’. As one man said, ‘You can only move on when you know what’s wrong with you.’
One man said when he got the diagnosis it was ‘vindicating’ to know his instincts about the diagnosis had been right all along, and a woman described how diagnosis confirmed to her, and others, that what she’d been experiencing hadn’t been normal. Diagnosis could also give access to care or medication and hence enable recovery. One woman described the diagnosis as ‘the start of my journey back from depression’.
Tom says diagnosis is the most important thing and gives a little bit of hope.
Some people weren’t happy about the ‘label’ of depression and felt that diagnostic labels were there more to help professionals rather than the young person. They described labels as a way to ‘categorise’ or ‘plant titles’ on them, but with no real benefit behind them in the form of interventions, for example. A couple of people had disagreed with the diagnosis they’d been given. One woman hadn’t been told the actual diagnosis and found out about it from elsewhere. For some, the depression diagnosis had also changed confusingly over years. One woman felt that although the label of ‘depression’ helped at first, it didn’t truly describe her feelings and experiences.
Mandy and Frankie say first they felt psychiatric diagnoses were just a way for the doctors to…
Rather than thinking of the clinical diagnosis, Joanna says she was broken. (Read by an actor).
Lisas diagnosis changed after a while but her medication stayed the same which she couldnt…
Oliver was diagnosed both with ADHD and bipolar disorder and was told that they had some similar…
For some, receiving the diagnosis was a ‘shock’, they felt ‘scared’ or ‘numb’. Several people described how these feelings gradually subsided. They ‘got used to’ the diagnosis and it ‘didn’t matter’ to them in the end. One woman said she didn’t care about the labels because ‘I am just me’.
Emma-Jane felt numb when she was given the diagnosis.
Mandy, Sian and Frankie say you become so used to the diagnostic labels that they become…
Very few people recounted negative outcomes of the depression diagnosis, apart from being shocked at first. But one woman said once she got the diagnosis she just stopped looking after herself and things got worse for her rather than better.
After Gemma was given the depression diagnosis, she let depression ‘take over’ her.
We also spoke to a few people with multiple psychiatric diagnoses. A couple of people had been given the diagnoses of borderline personality disorder or ADHD, in addition to depression. For a few, the initial depression diagnosis had changed to bipolar disorder. A couple of these people felt they didn’t neatly ‘fit’ the established narrow diagnostic criteria or categories and were just given a list of diagnoses to help the professionals to deal with them.
Not having a diagnosis
Several people we spoke with hadn’t been given a diagnosis. For some, this wasn’t a relevant issue, or they’d never been to a doctor about their low moods, whereas others were eager to get a diagnosis but hadn’t been referred for a specialist assessment. They wanted a diagnosis to gain access to medication or to validate their experiences. Some also said that a diagnosis would end the uncertainty around their ongoing mood problems. One man, for example, said that having a diagnosis would help to explain his behaviour and reduce the blame he was burdened with.
Sara says that without a formal diagnosis, she wont be able to get the medication she would want…
For helplines and other resources please see our ‘Resources‘ section.