Many health care providers can help determine if the diagnosis of clinical depression is appropriate in children, including licensed mental health counselors, pediatricians, other primary care providers, specialists seen for a medical problem, emergency room doctors, psychiatrists, psychologists, psychiatric nurses, nurse practitioners, physician assistants, and social workers. Due to the societal stigma that can be associated with receiving mental health treatment, pediatricians and other primary care doctors are often the first professionals approached for diagnosis and treatment of depression. The practitioner that is consulted to assess a child for depression will likely perform or refer for a thorough medical interview and physical examination as part of assigning the correct diagnosis. Depression is associated with a number of other mental health conditions, like attention deficit hyperactivity disorder (ADHD), autism-spectrum disorders, bipolar disorder, posttraumatic stress disorder (PTSD), and anxiety disorders, so the evaluator will likely screen for signs and symptoms of manic depression (bipolar disorder), a history of trauma, and other mental-health symptoms. Childhood depression also may be associated with a number of medical problems, or it can be a side effect of various medications, exposure to drugs of abuse or other toxins. Therefore, routine laboratory tests are often done during the initial assessment to rule out other causes of symptoms. Sometimes, an X-ray, scan, or other imaging study may be needed. As part of the evaluation, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help determine the risk of depression and suicide.