If you look for stuff enough (i.e., drug use/abuse), you're going to find it. But I think it's irresponsible to assume that patients are drug users just because they fit into a certain age group. I'm 28 years old, and I've never used marijuana. I can count on one hand the number of times I've consumed alcohol. Yet because I have a mental illness, doctors all too often assume I abuse substances, which I find offensive. Not only that, it often delays getting a diagnosis and treatment for real physical issues that are not caused by substance abuse.

Every time I see my primary care doctor for any issue, his office staff gives me a ten-question depression screening test. It doesn't tell you it's a depression screening test, but I've been around the block enough times to know what it is. I've taken my doctor to task about this because the particular questionnaire he uses is biased against people with chronic physical diseases. Loss of appetite and/or weight loss? Well, yes, I have an autoimmune disease that attacks my GI system, so those are typical symptoms. Lack of energy and fatigue? Yeah, my immune system's so busy attacking my own body that there's not a lot of energy left over for running marathons and such. The steroids, immunosuppressants, and chemo drugs I have to take don't help with that, either. Poor sleep quality? Yes, but that's because my symptoms are worse at night, so I'm constantly having to jump up out of bed to run to the bathroom, and the pain (which they refuse to adequately treat because OMG ADDICTION!) doesn't help with sleep either. Low mood? Hopelessness? Yeah, I'm sick all the time from an incurable disease that has left me crippled, housebound, impoverished, and isolated.

I do have depression, but even if I didn't, I'd test positive for depression simply because of my chronic physical illness. I don't trust my primary care doctor and his ten-question form to adequately diagnose or treat me for a mental illness. And when I go in because I need a refill on my asthma inhalers or because I sprained my ankle, they don't need to be screening me for depression anyway. I find it intrusive, and it can hamper adequate medical care.