How to describe depression to a doctor
Not a diagnosis — a vocabulary. Duration, function and change are the three things worth saying.
The hardest part of this appointment is not admitting something is wrong. It is finding words for a thing that does not really have any — and then worrying that the words you chose were too dramatic, or not dramatic enough, and that either way you have misrepresented yourself.
Here is the useful reframe: you are not being asked to diagnose yourself or to prove anything. You are being asked to describe. And clinicians are listening for three specific things, none of which require you to be eloquent.
The three things worth saying
Duration. How long, roughly. “Since about February” or “the last three months, worse in the last few weeks.” Approximate is fine. The distinction that matters clinically is weeks versus months, not the exact date.
Function. What it stops you doing. This is the one people skip, because it feels like complaining or making excuses — and it is the single most useful thing you can say. “I have called in sick four times this month.” “I have stopped answering my sister's messages.” “I am not cooking, I am just not eating.” Function is concrete, it is assessable, and it does not require you to rate your own suffering.
Change. How this differs from your normal. “I am usually the organiser and I have not made a plan since May.” A doctor does not know your baseline. You are the only source for it, and change from baseline is often the most informative thing in the room.
Duration, function, change. If nothing else survives the appointment, those three do the job.
Words that are easier than “depressed”
You do not need to use the word. Some people find it too big, or feel they have not earned it. Any of these work perfectly well:
Flat. Numb. Empty. Exhausted in a way sleep does not fix. Everything takes ten times more effort than it should. I am not enjoying anything. I feel like I am watching from behind glass. I cannot get started on anything. I am fine and then I am crying in the car.
Plain description beats clinical vocabulary every time. “I have stopped wanting to see anyone, and I used to like people” is more informative than “I think I have anhedonia.”
What accuracy actually means here
Two failure modes, and both come from trying to be fair rather than accurate.
Understating, because other people have it worse, or because on the day of the appointment you happen to feel alright. A good sentence for this: “Today is one of the better days. Most weeks are not like this.” That single line prevents an entire misreading.
Overstating, because you are frightened of not being taken seriously. It is understandable and it usually backfires — specifics are more persuasive than intensity. You do not need to make the case. You need to describe the week.
The most useful answer to “how bad is it?” is almost never a number. It is an example.
Talk about the worst of it, not the average
People instinctively describe how they are right now, in a well-lit room, at eleven in the morning, having got dressed and travelled somewhere. That is systematically the best you look all week.
Describe the bad end as well. What are the evenings like? What is it like at 4am? What is Sunday like? A clinician cannot see any of that, and the picture without it is misleadingly reassuring.
The question you can answer plainly
You will probably be asked, matter-of-factly, whether you have had thoughts of harming yourself or of being better off dead. It is a routine question, asked of everyone, and answering it honestly does not trigger anything dramatic.
Say the true thing. If the answer is yes, that is a piece of information they need in order to help you properly, and it is asked precisely so that you do not have to find a way to raise it yourself.
If the words will not come at all
Write them beforehand, when there is no clock running, and hand the paper over. Some people find it easier to get the description out by typing it first — talking it through with Nagi the night before, then taking the sentences that felt true. Either way, the description exists before the appointment does.
The short version
Duration, function, change. Plain words over clinical ones. Examples over ratings. Describe the bad end, not the version of you that made it to the appointment. And answer the difficult question straight — it is asked of everyone, and honesty gets you to the right help faster.
— Richard MacLean
Related: why can I not explain how I feel? and how to prepare for the appointment.
Nagi is a mental health companion, not a medical device, and nothing here is medical advice. If you are struggling, please reach out to a professional or someone you trust.