Steps of Clinical Assessment Step 1: Listen to the patient carefully, establish rapport, and develop a therapeutic alliance. Step 2: Confirm the diagnosis by identifying the full spectrum of signs and symptoms of depression and anxiety, and confirm a lack of a history of mania . Also exclude organicity especially hyper/hypothyroidism, Cushing disease, brain tumors, and any other physical conditions that can induce or mimic the symptoms of depression. A detailed medical history, physical examination, and relevant laboratory investigations (TFTs, Cortisol, DST, brain imaging, ECG, etc.) Should be obtained for this purpose. Exclude (depression/anxiety as) the impact of medications (e.g. propranolol), substances of abuse, and alcohol. Step 3: Assess the severity clinically and to monitor, with a standard scale, (HAMD/HAM-A, BDI/BAI, etc). Severity also influences the choice of treatment. Step 4: Assess the impact of the condition on the patient and family, including personal distre