Rising trend in depression and anxiety calls for more depression screening

MADISON, Wis.—May 19, 2021—With headlines such as "Depression triples in USA adults amid COVID-19 stressors," "Mental health needs rise with pandemic," or "Students in great need of mental health support," health care providers are identifying the rising trend in individuals suffering from depression and anxiety.

The U.S. Census Bureau reported that a third of American adults, more than 16 million, now show signs of clinical anxiety and depression amid the COVID-19 pandemic. This makes screening for depression more essential than ever. 

At your next primary care appointment, you may be asked to fill out a questionnaire, or your health care provider may ask you a series of questions about your moods, feelings, sleep habits, and other mental health topics. 

One such survey is called a Patient Health Questionnaire (PHQ-9) and offers primary care practitioners a tool to help detect and assess patients for early signs of depression and anxiety. Like screenings for other illnesses, depression screenings should be a routine part of your health care appointment. For a provider, it helps in evaluating the mental health and full well-being of a patient beyond just physical symptoms. 

Typically, providers screen adults and adolescents (12 years and older). The screening takes less than three minutes but can be useful in diagnosing depression and its severity. You can expect these nine questions:

1. Do you have little interest or pleasure in doing things?
2. Are you feeling down, depressed, or hopeless?
3. Do you have trouble falling or staying asleep or sleeping too much?
4. Are you feeling tired or having little energy?
5. Do you have a poor appetite or overeating?
6. Are you feeling bad about yourself, or that you are a failure or have let yourself or your family down? 
7. Do you have trouble concentrating on things, such as reading the newspaper or watching TV?
8. Do you move or speak so slowly that other people could notice? Or so fidgety or restless that you have been moving a lot more than usual?
9. Have you had thoughts that you would be better off dead or thoughts of hurting yourself in some way? 

When reviewing these questions, the choices to answer are not at all, several days, more than half the days, and nearly every day. These questions may seem simple, but they can be crucial in reaching individuals who might not otherwise seek professional medical advice. 

"It is essential to be honest with your responses. Your responses serve as a starting point or a guide to your provider," says Dr. Robert Kettler, Medical Director for WPS Government Health Administrators. A diagnosis rarely will come from screening alone. A provider will look at the number of symptoms, the frequency, and each symptom's duration when making a diagnosis. The provider will also rule out other conditions. 

These questions may also serve to help monitor your progress if you should receive a diagnosis of depression. It is not a one-time test; your situation and symptoms may change over time, and your responses may change as well.

"Increasing screening will allow our providers to identify those patients who need help more quickly," Dr. Kettler continued. “It is also important to note that if a patient is concerned about depression, the patient should raise the issue with the provider and not wait for the survey. In identifying these symptoms sooner, we will see significant changes in our health care system and patient outcomes. In addition, talking about mental health concerns can bring the silent illness into the light to continue to eliminate the stigma that still exists around the topic."