Can a Neurologist Diagnose Depression? 

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In this blog, we will answer the question “Can a neurologist diagnose depression?”, and also cover who is a neurologist, what is depression, symptoms of depression, diagnosis of depression, what does the research say, and treatment of depression. 

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Can a Neurologist Diagnose Depression? 

Yes, a neurologist can often help a person confirm their diagnosis of depression or if their depression has occurred due to other neurological conditions. 

Your primary healthcare provider or physician can treat a wide range of illnesses, from the flu to chronic disorders like hypertension.

Some illnesses, however, necessitate specific attention and treatment. Seizures, migraines, depression, Parkinson’s disease, multiple sclerosis, and stroke are examples of nervous system disorders. Your doctor will most likely refer you to a neurologist for the treatment of these disorders.

A neurologist can evaluate your symptoms, make a diagnosis, and supervise your therapy.

Who is a neurologist?

A neurologist is a doctor who specializes in diseases of the neurological system. The brain, nerves, and spinal cord make up your nervous system.

Pain, memory loss, speech difficulties, and other symptoms might result from conditions that affect these areas. These diseases frequently necessitate tests and treatments that your primary care physician cannot provide in his or her office or clinic.

The following symptoms may prompt your doctor to send you to a neurologist:

  • inexplicable discomfort
  • headaches 
  • headaches 
  • numbness
  • tremors or shaking 

A neurologist can evaluate your symptoms and perform tests to obtain a diagnosis and assist you in receiving the therapy you require.

What is Depression?

Depression is a type of mood disorder characterized by a continuous sense of despair and a loss of interest. It impacts how you think, feel, and act and can often lead to various mental and physical health-related issues. 

It’s also known as major depressive disorder or clinical depression. It may interfere with your day-to-day functioning and you may feel that living isn’t worthwhile. 

Symptoms of depression 

  • Losing interest in things you enjoyed before
  • Changes in your appetite
  • Weight loss or weight gain
  • Sleep-related problems: either insomnia or sleeping too much
  • Feeling fatigued and loss of energy most of the time
  • Feeling hopeless and worthless
  • Trouble in thinking, concentrating or making decisions 
  • Suicidal thoughts 

If you’re facing this, it may be a good idea to seek the help of a therapist or other mental health professional. You can find a therapist at BetterHelp who can help you learn how to cope and address it.

Diagnosis of depression

Your doctor may make a depression diagnosis based on the following factors:

Examination of the body

Your doctor may conduct a physical examination and ask you health-related questions. Depression may be linked to an underlying physical health issue in certain circumstances.

Tests in the lab

A complete blood count or a thyroid test, for example, may be performed by your doctor to ensure that your thyroid is operating appropriately.

Evaluation by a psychiatrist

A psychiatrist’s evaluation is required. Your mental health professional will ask about your symptoms, thoughts, feelings, and behavioral patterns. You may be asked to fill out a questionnaire to assist in answering these questions.

DSM-5

The criteria for depression published in the Diagnostic and Statistical Manual of Mental Disorders may be used by your mental health practitioner.

Can a neurologist diagnose depression?

Neurologists may place a greater emphasis on the neurologic issue at hand, overlooking or dismissing depression symptoms. That is why it is critical that you tell them how you feel. 

For example, if a prescription medicine is causing your depression, your doctor may be able to prescribe an equally effective treatment that is less likely to harm your mood. 

More than 200 pharmaceutical drugs have been linked to depression, including those for high blood pressure, gastric reflux disease, pain, anxiety, and hormonal disorders. Furthermore, taking three or more drugs raises your chance of depression. 

Telling your doctors will allow them to examine for ailments like thyroid or other endocrinologic diseases, dietary difficulties or vitamin deficiencies, infections, and autoimmune disorders, which are all linked to depression. 

Once you’ve been diagnosed with depression and your doctor has ruled out other possibilities, he or she will likely recommend you to a psychiatrist, who can then prescribe various medications, therapy programs, and other coping mechanisms. 

What does the research say about neurology and depression? 

Two experienced neurologists, Angela EP Bouwmans and Wim EJ Weber did a study in which they took the history and examined 104 patients with a recent-onset parkinsonian illness, assessing depression and cognitive impairment. 

All patients were given a Hamilton Depression Rating Scale test and a Scales for Outcomes in Parkinson’s Disease-Cognition test on the same day (SCOPA-COG).

The neurologists’ sensitivity to the problem of depression was low: 33.3 percent. The specificity, on the other hand, ranged from 90.8 to 94.7 percent. The sensitivity of the patients was higher, but their specificity was lower. 

On the subject of Cognitive Impairment, the neurologists’ sensitivity was poor, ranging from 30.4 to 34.8 percent; however, their specificity was great, at 92.9 percent. In comparison to the number of neurologists, the patients’ sensitivity and specificity were both lower.

Neurologists’ intuition and clinical judgment alone are inadequate in diagnosing depression or cognitive impairment in patients with recent-onset parkinsonian symptoms due to low sensitivity despite good specificity.

Treatment of depression

The most effective way to treat depression is by using medications along with therapy. 

Medications

Selective serotonin reuptake inhibitors (SSRIs) are drugs that block the reuptake of serotonin (SSRIs). SSRIs are frequently prescribed by doctors as these medications are thought to be safer and have fewer negative side effects than other forms of antidepressants. 

Citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), and vilazodone are examples of selective serotonin reuptake inhibitors (SSRIs).

Serotonin-norepinephrine reuptake inhibitors (SNRIs).- Duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla), and levomilnacipran are examples of SNRIs.

Atypical antidepressants

These antidepressants don’t belong in any of the other antidepressant categories. Some of the drugs available include bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone, and vortioxetine.

Therapy 

Psychotherapy is a broad term for talking with a mental health expert about your depression and related difficulties in order to get help. Talk therapy or psychological therapy are other terms for psychotherapy.

Depression can be treated using a variety of psychotherapies, including cognitive-behavioral therapy and interpersonal therapy. Other forms of therapy may be suggested by your mental health practitioner. Psychotherapy can assist you in the following ways:

Adapt to a crisis or other pressing issue

Replace unhealthy, negative ideas and habits with healthy, positive ones.

Examine your relationships and experiences, as well as how you interact with others.

Improve your problem-solving and coping skills.

Identify the factors that contribute to your depression and alter the habits that aggravate it.

Alternative therapy formats

Alternatives to face-to-face office appointments for depression therapy are available and may be a helpful option for some people. Therapy can be delivered in a variety of ways, including computer software, online sessions, videos, or workbooks. A therapist can guide the program, or it might be partially or completely self-contained.

Before deciding on one of these formats, consult with your therapist to see if they are appropriate for you. Also, see if your therapist can offer a reliable source or program. Some may not be covered by your insurance, and not all developers and online therapists are qualified or trained.

Neurologists and Antidepressants

The influence of neurological diseases and mood disorders on human health and life, as well as health care and society as a whole, cannot be overstated.

Stroke, neurodegenerative, and demyelinating illnesses are among the world’s major causes of mortality and disability, while depression is linked to up to 60% of suicides. 

Antidepressants are employed not just in psychiatric practice, but also in neurology practice. In neurological patients, antidepressants are prescribed to treat depression, chronic pain syndromes and neuropathic pain, panic attacks, eating disorders, premenstrual syndrome, and migraine prevention.

The most challenging job for neurologists is to recognize depressive disorders, which are frequently associated with neurological illnesses. Antidepressants’ major feature is their capacity to improve sad mood without affecting normal mood or having a stimulating effect. 

Antidepressants have anti-anxiety, sedative, anti-phobic, anti-panic, and somatic effects, among other things. 

Antidepressant prescriptions are warranted not only from a psychiatric (reducing depression and minimizing the chances of suicide) but also from a neurological standpoint when depression is found in patients with neurological illness (reducing the risk of complications of neurological pathology and premature mortality from it).

Frequently asked questions (FAQs): Can a Neurologist Diagnose Depression?  

Is it possible for you to consult a neurologist for depression?

Although neurologists can not treat mental illnesses such as depression, it is crucial to discuss your mental health with them. Inform your neurologist if you’ve been diagnosed with a mental health disorder. It’s possible that it’s creating symptoms that are comparable to those of neurological disorders.

What is the difference between neurological and psychiatric disorders? 

The nervous system malfunctions or is damaged, resulting in neurological disorders. The brain, spinal cord, and nerves are all included.

Epilepsy, multiple sclerosis, Huntington’s disease, Parkinson’s disease, and Alzheimer’s disease are among the most well-known neurological illnesses.

Disturbing behavior and a patient’s emotional condition are common symptoms of psychiatric disorders. A psychiatrist, psychologist, or professional therapist is responsible for the treatment of these disorders.

Some of the most common psychiatric disorders include neurodevelopmental disorders (ADHD, Autism), Bipolar and Related Disorders (mania, depression), Anxiety Disorders (social anxiety, generalized anxiety, panic, separation anxiety, and phobias), Stress-Related Disorders (PTSD), Dissociative Disorders (amnesia), Eating Disorders (Anorexia, Bulimia), and Addiction.

Therapy, medicine, or a mix of the two may be used to treat these problems.

On the first appointment, what will a neurologist do?

A neurologist will most likely ask you to engage in a physical assessment and a neurological evaluation during your initial consultation. Muscle strength, sensitivity, reflexes, and coordination are all measured during neurological exams. You may be required to undertake further tests due to the neurological system’s intricacy.

Do neurologists operate on patients?

Neurologists and neurosurgeons both diagnose and treat nervous system disorders, however, neurologists do not do surgery. Neurologists are focusing their efforts on diagnosing neurological diseases that can be treated with medications or other therapies or require close monitoring.

Is it possible for anxiety to induce neurological symptoms?

High anxiety, according to researchers, may induce nerve firing to occur more frequently. Tingling, burning, and other unpleasant sensations might result, which are also signs of nerve damage and neuropathy. Muscle cramps, which can be an indication of nerve injury, can also be caused by anxiety.

Is it better to see a neurosurgeon or a neurologist?

The distinction between a neurologist and a neurosurgeon is self-evident. While a neurosurgeon may conduct surgery to alleviate medical problems, neurologists treat specific disorders with medications and other ways. Neurologists and neurosurgeons work in tandem.

References

https://www.ejmed.org/index.php/ejmed/article/view/448#:~:text=The%20most%20 difficult%20test%20for,without%20showing%20a%20stimulating%20effect.

https://threevillageneurology.com/how-can-a-neurologist-treat-your-depression.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3465198/
https://www.brainandlife.org/articles/why-its-important-to-let-your-neurologist-know-if-you
https://www.healthline.com/health/general-use/why-would-i-be-referred-to-a-neurologist#conditions-neurologists-treat
https://optimistminds.com/can-neurologists-treat-depression/
https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

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