Self diagnosis is an easy trap to fall into when dealing with issues of mental health. When shit hits the emotional fan, having the power to give problems a name gives us a much-needed sense of control, or, at the very least, a way to talk about them. Online depression tests can equip us, to some extent, to do this. But according to psychologist and depression expert Jonathan Rottenberg, Ph.D., they’re definitely no substitute for a clinical interview.
Diagnosing depression is a lot more complicated than answering a series of questions, Rottenberg, a researcher and professor at the University of South Florida, told Inverse. Physicians ask about depressive symptoms — low mood, loss of interest or pleasure, fatigue, and problems with concentration and appetite — and demand more than “yes” or “no” answers.
“For each question, a judgement must be made as to whether the problem is over the clinical threshold,” says Rottenberg. What this means is that it’s not particularly useful to know that someone simply has, say, trouble sleeping — physicians need to know how much trouble so they can assess whether it’s enough cause for alarm. When we’re emotionally overwhelmed, accurate self-assessment — the kind required to answer online quizzes — isn’t exactly guaranteed. “An experienced clinician can make that decision much better than a patient,” he says, noting that it’s the overall patterns in a patient’s answers that determine whether their distress is, as he puts it, “clinically significant.”
Online depression kinds of questionnaires can ask the right kinds of questions — and allow for nuanced answers — but he thinks they’re by no means a tool for diagnosis. Rottenberg hasn’t endorsed any yet. But that’s not to say he thinks they’re completely useless: Quiz questions, like “Does my future seem hopeless?” or “Have I lost interest in things I used to love?” could, he says, lead someone to seek help. The problem is that amateur diagnosis could be more debilitating than illuminating.
In the end, it’s what quiz-takers do with their online results that’s important. “Self-screening needs to be supplemented with additional resources that people can turn to get more help in the event of a positive screening,” says Rottenberg.
He doesn’t disapprove of online tests, but he also thinks it’d be be irresponsible to say they could ever substitute for a good clinical interview. Including the appropriate disclaimers — and suggestions on how to follow up on the test result with the appropriate professionals — is key. Tempting as it is to deal with isolation, depression shouldn’t have to be tackled alone.