Diagnosing Depression And Other Testing Methods
The doctor may include other standard tests as part of the initial physical exam. Among them may be blood tests to check electrolytes, liver function, toxicology screening, and kidney function. Because the kidneys and liver are responsible for the elimination of depression medications, impairment to either of these two organs may cause the drugs to accumulate in the body.
Other tests may sometimes include:
- CT scan or MRI of the brain to rule out serious illnesses such as a brain tumor
- Electrocardiogram to diagnose some heart problems
- Electroencephalogram to record electrical activity of the brain
How To Read Blood Test Results
While every laboratory or test-providing company may structure their result reports differently, they all must include the same components as mandated by federal legislation.
Some of that may be administrative content, such as the name of the person who did the blood test, the date the test was done, and the name of the doctor who ordered the test.
When it comes to understanding the results, you can look for the following :
- Quantitative test result. Results will be typically written out numerically in cases when the test measured the quantity of something. For example, if the test measured the amount of cholesterol in your blood.
- Abnormal markers. Often, a laboratory report will include some kind of marker to let you know if a result is outside the normal interval, and therefore abnormal. For example, you may see the letter H to indicate high, the letter L to indicate low, or the acronym WNL for within normal limits. You may see an asterisk and some additional comments in text if your results come out as highly abnormal. In this case, youll typically get a call from your doctor.
- Reference range. Every laboratory will have its own reference range for each type of test. Typically, this reference range will be written in your laboratory report next to the numerical value of your result so you are able to see where your result falls in the range.
To a blood test, the nurse or technician:
Future Lab Tests For Depression
While they are not yet in common use by most health care providers, in the realm of psychological research there is much interest in the potential of biomarkers to help diagnose depression and other psychiatric conditions.
There are many factors that determine whether someone develops depression in their lifetime, including genetics and environment.
Research also continues to show how the brain and the body are inextricably connected the health of one influences the health of the other.
Some studies have been looking for a potential connection between levels of inflammation in the body and depression. Others are investigating how the gut microbiome might influence mental health.
A study published in 2013 explored the possibility of a connection between elevated cortisol levels in young adults and depression. In 2015, a study at UC San Diego proposed changes in a specific gene linked to the X chromosome may contribute to mental illness in women.
One day, we may be able to screen a persons genetic information, measure the levels of inflammatory markers in their blood, and look for changes in the structure of their brain to determine their risk for depression, diagnose the condition, and find the most effective treatmentbut were not there yet.
For more mental health resources, see our National Helpline Database.
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Blood Tests For Depression
Could a simple blood test detect the efficacy of antidepressants on those with depression? A new study suggests its a possibility.
It has long been known that first-line anti-depressants are not effective treatment options for everyone. While some people may find success with their first treatment option and others may have to work through a few options before settling on a medication that works, for almost a third of people current antidepressant medication does not work. This is frustrating, not least because many antidepressants can have unpleasant side effects, which the patient then has to deal with without any relief from the initial issue of depression.
This could change.
For the first time a study has found reliable links between biomarkers in those who live with depression and their likelihood of response to anti-depressants.
A paper, published in the International Journal of Neuropsychopharmacology, has found there are high levels of inflammation evident in those individuals resistant to traditional antidepressant medication. This could mean that something as simple as a blood test could help determine the likelihood of an individual responding positively to traditional antidepressants.
The findings suggest that the identification of biomarkers in predicting treatment response could not only significantly reduce the social and economic burden of depression in the community but importantly, improve the quality of life of patients.
Combining Body And Mind
The study also raises interesting questions regarding the comorbidity of depression with generalized inflammation, Redei said.
Along with Pariente, she is eager to find ways to treat people suffering from depression more effectively. They both believe it is important that clinicians recognize that depression is about more than just the mind.
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Can Blood Tests Detect Any Mental Health Condition
Blood tests are growing as a method of detecting mental health conditions.
For example, a 2016 study identified biomarkers for bipolar disorder using blood tests with about a 70% accuracy rate.
Researchers were also able to find 20 biomarkers that could distinguish between those with bipolar disorder and a control group.
Also, the study research suggests that individuals with bipolar disorder could receive an incorrect diagnosis because it overlaps with the symptoms of psychosis in schizophrenia and many other disorders symptoms.
The result points to a need for a biomarker panel specifically for bipolar disorder.
Other conditions folks with bipolar disorder are often misdiagnosed for include:
2021 study also supported the need for blood biomarker tests health professionals can use to diagnose bipolar disorder, which researchers found to be misdiagnosed up to 70% of the time. Researchers went on to find biomarkers that could help evaluate patients for depression and mania.
Although the test isnt yet common practice, it could eventually be a way to diagnose mental health disorders more accurately.
The Focus On Metabolizing The Drug
In recent years, pharmacogenomic testing has received greater attention as a tool to personalize medication selection and is often used to treat patients with health conditions such as cancer and heart disease. Many in the medical community hope the testing can also be helpful in treating people with major depressive disorder. Research has been limited, however, on demonstrating improved clinical outcomes.
Currently, most of the pharmacogenomic testing focuses on a variant in the genes that encode hepatic CYP450 enzymes, a pathway that metabolizes drugs in the liver. Oslin and his team used a commercial battery of genes that focused on the CYP450 system. The battery tested eight genes, six of which test for variants in enzymes of the liver.
What do genes have to do with antidepressants?
The genes we tested dont actually relate to depression, Oslin says. They relate to how a person metabolizes the drugs once theyre in the body. Some of these genes will cause the medications to metabolize much faster than normal. Others will cause the drugs to metabolize much slower than normal, which means youll end up with a lot of medication in your body.
A drug-gene interaction is an association between a medication and a genetic variant that may affect a patient’s response to drug treatment. Having that information helps the provider select the appropriate dosage for a specific patient.
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New Blood Test Targets Depression
Health editor, BBC News online
UK scientists have developed a blood test to help doctors pick the best drug for patients with depression.
Medics currently have to rely on trial and error, meaning around half of the time the first type of antidepressant given fails to work.
The researchers from King’s College London say checking a patient’s blood could help identify accurate treatment.
Those who test positive for inflammation need more aggressive therapy from the outset, they say.
So far the researchers have tried out their blood test on a small number of volunteers – 140 people with depression.
They say they will need to do a large trial to check how well it might work in the real world.
The blood test, described in the International Journal of Neuropsychopharmacology, is the culmination of years of investigation.
It looks for two specific markers of inflammation – a compound called macrophage migration inhibitory factor and another called interleukin-1beta.
In the study, patients with high levels of these markers were unlikely to respond to conventional, commonly prescribed SSRI and tricyclic antidepressants.
Lead researcher Prof Carmine Pariante said this knowledge could help tailor treatment to the individual – although the test needs more work and development to make sure it would be accurate enough to use more routinely.
Antidepressants are safe but they can have side effects.
Who Orders My Blood Tests
Your doctor typically orders blood tests for you during a physical, checkup, or an appointment intended to screen for a specific condition.
Its possible to order your own blood tests without a doctor through laboratories like LabCorp and Quest Diagnostics, but health insurance may not cover these tests.
While such blood tests may more accessible and convenient, it may be harder to interpret the results without a medical professional.
Some blood testing facilities may also not give you accurate results.
One infamous case of this is Theranos. The California biotechnology firm shut down in 2018 when an investigation uncovered lies and fraud around the accuracy of its private blood-testing technology.
Currently, litigation is underway against the founder and chief executive of the company, Elizabeth Holmes.
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Baseline Crp Predicted Treatment Success
When they analyzed the results, the researchers found that differences in remission rates correlated to differences in depression medication, depending on baseline CRP levels.
The results showed that patients whose baseline CRP levels were below 1 milligram per liter responded better to escitalopram alone, whereas those with higher levels responded better to the combined medication.
Previous studies have tried to tie CRP to antidepressant success, but Prof. Trivedi says that they were looking at much higher levels of CRP.
He explains that in his view, you dont need that high of an inflammation to experience the sickness of depression. Even a little inflammation may be sufficient for the patients to experience some of these symptoms of depression.
The team now plans to carry out larger studies to explore the link between CRP and success with other antidepressants, and also to look for other biological markers of depression treatment effectiveness.
Both patients and primary-care providers are very desperately looking for markers that would indicate there is some biology involved in this disease. Otherwise, we are talking about deciding treatments from question-and-answer from the patients, and that is not sufficient.
Prof. Madhukar Trivedi
Sexually Transmitted Infection Tests
Many sexually transmitted infections can be diagnosed using a blood sample. These tests are often combined with urine samples or swabs of infected tissue for more accurate diagnoses.
The following STIs can be diagnosed with blood tests:
Blood tests arent always accurate right after contracting an infection. For an HIV infection, for example, you may need to wait at least a month before a blood test can detect the virus.
A Blood Test May Help Pinpoint The Right Antidepressant For You
When doctors determine the best medication for a person with depression, they generally rely upon little more than guesswork and patient self-reports, due to insufficient medical evidence. Research out of UT Southwestern Medical Center previously suggested that such practices were insufficient, and a new study, published in Psychoneuroendocrinology, provides additional diagnostic information that may change the way depression is treated.
The research team drew upon a large body of research that links low levels of inflammation in the body with depression. They say a blood test for an inflammatory biomarker, known as C-reactive protein , can significantly improve the success rate of two common antidepressants for depressed patients.
Lead author Madhukar Trivedi, a professor of psychiatry at UTSMC and director of the Center for Depression Research and Clinical Care, says doctors typically pick an antidepressant for their patients in one of three ways: personal experience matching the perceived benefits of one drug with a certain type of patientâs needs or having the patient pick a drug by ruling out the unwanted side effects of other drugs. âThere isnât a strong evidence base to support one way over another,â he tells mental_floss.
Not only do these SSRI antidepressant drugs promote higher levels of retention of the âfeel goodâ neurotransmitters serotonin and dopamine, they trigger an immune response that blocks inflammatory molecules called cytokines.
Ptsd Affected Treatment Response
In supplemental material, the researchers noted that the presence of PTSD in patients had a profound negative impact on remission from depression. Basically, the patients with PTSD responded poorly to antidepressants. We know from the literature that PTSD doesnt respond well to antidepressants, Oslin says. The main psychotherapies for patients with PTSD, he points out, are cognitive processing therapy and prolonged exposureboth widely used in VA.
One of the special ways that we did this study is as a pragmatic study in frontline clinical practices, Oslin says. We used clinicians and their patients. The providers all had to say that the patients were being treated for depression. But they could have had comorbidities, and many of them had comorbid PTSD, which had a big influence on treatment outcomes in a negative way.
For providers who would like to do pharmacogenomic testing in the future, the burden is low across the board, says Oslin. Theres no risk to patients in getting the test.
The costs actually are very low because the results can be used over the patients lifetime, Oslin says. So youre not talking about a test that has a shelf life of only five minutes. And theres really no risk to getting the test. Youre just getting the cheek swab or a blood test. Cost is low, risk is low, and the population benefits are probably low. But overall, this test likely benefits some patients substantially.
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What Happens During A Tca Screen
A TCA screen can be done as a blood test or a urine test.
During a TCA blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a TCA urine test, you will need to provide a sample of urine into a sterile cup. Your provider will give more information on how to collect your sample.
What Is It Used For
A TCA screen is used to:
- Help your health care provider prescribe the right dose of a TCA
- Find out if you are misusing TCA . The test may be included as part of a drug screen, a test that checks for the presence of several different prescription and illegal drugs.
- Diagnose a TCA overdose. Prompt treatment of an overdose can be lifesaving.
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Objective Tests Could Transform Early Diagnosis
Objective testing could be of huge significance to patients going through what is currently an extremely slow process of diagnosis.
For bipolar disorder in particular, it can take years for the full array of symptoms to evolve.
Sydney psychiatrist, Dr Sonia Kumar, says that quite often bipolar disorder will first manifest itself as depression, with manic symptoms emerging later.
Other times, symptoms may be present but so low on the spectrum that diagnosis is unclear until they evolve.
If there were a biological test that could clarify these variables along with clinical assessment, says Kumar, clinicians could start accurate treatment earlier, which could mitigate a lot of suffering before it even happens.
Research associate Katrin Inci believes that an early diagnosis of her bipolar disorder could not only have saved her years of unresolved suffering, but also the severity to which her episodes escalated after diagnosis.
She was diagnosed with depression at age 13 and prescribed Zoloft, a type of antidepressant that is well known for inducing mania in bipolar patients.
spun me into a manic episode that lasted until I was 19, when I was hospitalised for the first time, she said.
After her hospitalisation, when Inci finally received a correct diagnosis, she began what would be 10 years of trying new medications, navigating bipolar episodes and searching for wellness.
She believes that had she been diagnosed correctly at 13, her illness would not have become so severe.
If The Diagnosis Is Depression
Depression is treatable. Consequently, a depression diagnosis can start you on the road to a healthier life without feelings of helplessness, hopelessness, and worthlessness.
Once your doctor makes a depression diagnosis, you need to follow the treatment program to get better. It’s important to take the medications as prescribed. You also need to follow through on making lifestyle changes and working with a psychotherapist if that’s what your doctor recommends. Millions of people with depression suffer needlessly because they don’t get professional help that starts with a doctor’s diagnosis.
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