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Mental Health (Anxiety & Depression) Contributors Test Panel

$449.00

HSA/FSA Accepted

This panel is designed for people experiencing symptoms of anxiety or depression who want to understand whether physical health factors may be contributing to or worsening those symptoms. It tests 41+ biomarkers that provide insights on thyroid function, stress hormones, nutritional levels, and indicators of general health, anemia, and hormonal balance. Results may serve as a baseline for potentially modifiable contributors. This test does not diagnose anxiety, depression, or any mental health condition. Read more

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Millions of Americans experience symptoms of a mental health condition each year, and the demand for care is increasing.¹ According to the CDC, 12.1% of adults experience anxiety (including feelings of worry and nervousness), while 4.5% of adults experience feelings of depression, on a regular basis.² Both anxiety and depression can range in severity and may be severe enough that they interfere with daily functioning, yet physical health conditions are an often-overlooked contributor. Thyroid disorders, hormonal imbalances, nutritional deficiencies, and anemia can all produce or worsen symptoms that closely mirror those of anxiety and depression – including fatigue, mood changes, and difficulty concentrating.

This test measures 41+ biomarkers to help identify whether any of these physical health factors may be playing a role in symptoms. Results can give you and your healthcare provider a clearer, more comprehensive picture – whether you are trying to understand new or worsening symptoms, establishing a baseline before starting mental health medications, or monitoring against that baseline.

Please note: These tests do not diagnose or rule out anxiety, depression, or any other mental health condition, and most mental health conditions cannot be diagnosed through lab testing alone. As comprehensive mental health evaluation by a qualified clinician remains the gold standard for diagnosing mental health issues, please see your healthcare provider to determine next steps.

Please also note: For best results, it is recommended that you schedule an appointment for sample collection in the morning only (between the hours of 7am and 9am).

No doctor’s visit needed. Buy this mental health contributors test online and visit a nearby Quest location.

Sample type: Blood
Test type: In Person
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This test may be right for you if any of the following are true:

You have depression, severe fatigue, or brain fog that have appeared without an obvious psychological cause or trigger
You have anxiety or depression symptoms that accompany physical symptoms such as fatigue, hair loss, or unexplained weight changes
You have noticed changes in your libido, menstrual cycle, or energy levels alongside mood symptoms
You are in perimenopause transition or experiencing hormonal changes and have noticed new or worsening mood symptoms
You are under chronic or prolonged stress and want to understand how it may be affecting physical and hormonal health
You have been diagnosed with a mental health condition and want to establish a baseline for tests related to general, hormonal, or nutritional health
You and your healthcare provider are interested in obtaining baseline laboratory information before starting certain medications
You want additional information about your thyroid health, vitamin status, iron levels, or other biomarkers that may affect overall wellbeing

This test is NOT right for you if any of the following are true:

You are experiencing thoughts of self-harm or suicide
You have a history of suicide attempt or self-injurious behavior
You have recently had a psychiatric hospitalization
You are experiencing symptoms of psychosis or mania

If you are experiencing thoughts of self-harm or suicide, call or text 988 (Suicide & Crisis Lifeline), call 911, or seek emergency medical care immediately.

This panel includes:

A complete blood count (CBC) measures several important components of your blood and can provide insight into your overall health. It may help identify signs of conditions such as anemia, infection, inflammation, immune system disorders, or certain blood-related conditions. The test evaluates red blood cells, which carry oxygen throughout the body; white blood cells, which help fight infection; and platelets, which support normal blood clotting. A CBC also measures hemoglobin, hematocrit, and additional markers that can help your healthcare provider better understand your blood cell health and function.

A CMP (also known as a Chem 14) is a broad screening tool that assesses 14 different substances to evaluate sugar (glucose) levels, kidney function, liver function, and electrolyte imbalance. This panel of tests is often used by healthcare professionals to detect and monitor various abnormalities, including nutrient balance, diabetes, and kidney and liver disease.

Thyroid-stimulating hormone (TSH) levels in the blood are measured to evaluate thyroid function, which is critical for regulating weight, energy, body temperature, mood, and overall health. If your TSH levels are abnormally high or low, this may indicate that your thyroid is either underactive (hypothyroidism) or overactive (hyperthyroidism). If test results identify abnormal TSH levels, free thyroxine (T4) blood levels will be evaluated using your submitted sample to provide information needed to accurately diagnose hypothyroidism.

The adrenal glands above the kidneys produce cortisol. Cortisol is the body’s main stress hormone and fluctuates throughout the day. It aids in regulating inflammation, blood pressure, blood sugar, sleep cycles, and metabolism — especially in stressful situations. Normally the body will regulate cortisol levels to deal with stress and pressure, but sometimes our bodies remain in a stressed state for too long. Too much (hypercortisolism) or too little (hypocortisolism) cortisol can result in the body’s inability to complete its normal functions and may lead to health problems such as anxiety, depression, headaches, memory issues, digestion problems, trouble sleeping, weight gain, and heart disease. This cortisol blood test measures the morning level of cortisol present in your blood. This test uses a single blood draw collected during that peak window (7am-9am) to provide a snapshot of your cortisol level at its highest point in the day.

DHEA is a hormone, produced in the adrenal gland, that helps make other hormones like testosterone and estrogen, and levels usually peak in early adulthood and slowly fall with age. Testing DHEA-S levels, the sulfated form of DHEA, helps healthcare providers determine the source of androgens in hyperandrogenic conditions like polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), when testosterone levels are normal.

Insulin-like growth factor 1 (IGF-1) is a hormone made by the liver that is involved in stimulating cell growth, especially those in your bones and muscles. Because IGF-1 is controlled by growth hormone and remains relatively stable in the blood throughout the day — unlike growth hormone itself, which fluctuates significantly — it is commonly used as a reliable indicator of growth hormone activity. Measuring IGF-1 levels can help healthcare providers assess whether growth hormone production is too high, too low, or within a normal range, and is particularly useful for monitoring hormone therapy or investigating symptoms that other hormone testing has not fully explained. Abnormal IGF-1 levels do not diagnose but may point to conditions related to growth hormone excess or deficiency, or support ongoing monitoring of a known hormone condition.

The following markers are tested to assess different aspects of iron metabolism in your body:

Iron: Measures the amount of iron in your blood. Iron is an essential mineral needed for proper growth and development in the body. Iron is needed by red blood cells to transport oxygen throughout the body. A low iron level can point to anemia, which may be caused by diet, injury or blood loss, pregnancy, heavy exercise, and certain conditions
Total iron binding capacity (TIBC): Measures how well your blood attaches itself to iron to move it around your body
Ferritin: Measures the amount of ferritin in the blood, a protein in the blood that contains iron and helps you understand how much iron your body is storing

Vitamin B9 (folate) is a water-soluble vitamin that helps your body make red and white blood cells; grow tissues; build DNA; and turn food into energy. This test reflects recent dietary intake and is affected by recent meals. This vitamin is important during pregnancy to help prevent congenital disabilities (conditions present at birth) of the brain (eg, anencephaly) and spine (eg, spina bifida). Folate helps with the healthy development of fetal tissues and cells. Folate deficiency is very rare in the US today. People who are deficient in folate may not have any symptoms or may have symptoms of anemia, an irregular heartbeat, weakness, tiredness, or nerve damage. Early detection is important to prevent irreversible damage over time, especially to the nervous system.

Vitamin B12 (cobalamin) is a water-soluble vitamin that helps your body make red blood cells, create DNA, and keep your nervous system healthy. People who are deficient in cobalamin may not have any symptoms or may have symptoms of anemia, depression, weakness, tiredness, memory loss, or nerve damage. Early detection is important to prevent irreversible damage over time, especially to the nervous system.

This test measures the amount of 25-hydroxyvitamin D, the most reliable indicator for the overall level of vitamin D in your body. Vitamin D is an essential fat-soluble vitamin that is necessary for the proper functioning of your heart and blood vessel health, insulin regulation, and mood. Vitamin D helps regulate calcium and phosphorus, which are essential nutrients for strong bones and healthy cells. It can also help the immune system fight infections and is known to be involved in muscle function and protein production.

Your body produces vitamin D after exposure to sunlight or from consuming certain foods and supplements. It then stores an inactive form of vitamin D in fat cells until it's needed. Your liver changes the inactive form of vitamin D into the storage and transport form of vitamin D called 25-hydroxyvitamin D. The kidneys then change 25-hydroxyvitamin D to the active form that your body uses. When levels are low, your body may not have enough to support the functions that depend on it.

Low levels of vitamin D can lead to bone pain, muscle weakness, or depression. Abnormal levels of vitamin D can indicate bone disease, nutrition disorders, or other metabolic complications. Vitamin D is naturally found in foods such as meat, seafood (trout and salmon), cod liver oil, or fortified dairy and plant-based milk products. It can also be found in supplement form.

Catecholamines (dopamine, epinephrine, and norepinephrine) are a group of chemical messengers (hormones and neurotransmitters) made by the brain, sympathetic nervous system, and adrenal glands. They help your body respond to physical and emotional stress and help control your rapid “fight or flight” response. Chronically high levels can lead to severe cardiovascular strain, hypertension, and anxiety. This panel measures total catecholamines as well as each of the three individual markers – epinephrine, norepinephrine, and dopamine – providing a more complete picture of how your stress response system is functioning.

Dopamine plays a particularly important role in mood regulation, motivation, and emotional wellbeing, and imbalances have been associated with symptoms of depression and anxiety.

Epinephrine (also called adrenaline) and norepinephrine work together to trigger the fight-or-flight response during fear or acute stress. Epinephrine increases heart rate, raises blood pressure, and opens airways. Norepinephrine increases alertness, focus, and arousal. Chronically abnormal levels of either can be associated with anxiety, nervousness, restlessness, high blood pressure, and sweating. Please note that catecholamine testing is not a standard diagnostic tool for anxiety or depression, and for some, may not reliably reflect central nervous system activity relevant to mood.

Anxiety and depression can present across a range of psychological, physical, and behavioral symptoms. Because many of these symptoms can also be caused or worsened by underlying physical conditions and overlap with many other conditions, identifying any physical contributors through lab testing can be an important part of a mental health plan built with a healthcare provider.

Signs and symptoms of anxiety include:

Psychological changes, such as racing thoughts, unending worry, feeling like something dangerous or bad is about to happen, with difficulty focusing on anything other than those thoughts
Physical changes, such as rapid heart rate, sweating, shaking, digestive issues, or hyperventilation
Behavioral changes, such as feeling restless, irritable, or a desire to avoid situations that cause discomfort or anxious feelings

Signs and symptoms of depression include:

Psychological changes, such as loss of interest in activities previously enjoyed, recurring thoughts of death or dying, feeling worthless, or having excessive guilt
Physical changes, such as appetite or weight fluctuations, chronic fatigue, unexplained headaches, pains, or digestive problems
Behavioral changes, such as difficulty in making decisions, trouble concentrating, or isolating from friends and family

If you are experiencing thoughts of self-harm or suicide, call or text 988 (Suicide & Crisis Lifeline), call 911, or seek emergency medical care immediately.

Purchaser: You must be 18 years of age or older to purchase a test on questhealth.com.

Patient: This test can be performed on patients between 18 and 100 years old.

Sample collection: This test requires sample collection at a Quest Diagnostics location. Collection is not available in AZ, HI, or PR.

For best results, it is recommended that you schedule an appointment for sample collection in the morning only (between the hours of 7am and 9am). Fasting (not eating or drinking anything except water) for 8-12 hours is recommended. Certain supplements and medications can interfere with your test results. If you are concerned about any of your supplements or medications impacting your results, talk to your healthcare provider before your sample is collected to see if you should stop taking them and for how long. Please note: tobacco use and strenuous exercise in the days prior to collection may impact results.

Results are typically available within 5-7 business days of providing your sample - this includes sample processing, testing, and a clinical review before release.

You will receive a secure link to your email when your results are ready. They will be available in a clear, easy-to-read report. If you have, or create, a MyQuest® account, your results may also be available there - and for larger panel tests, you may be able to see individual results as each becomes available.

You may receive an alert call from an independent healthcare coordinator if some of your test results are outside of the expected ranges. Included with your purchase, you have the ability to talk to an independent healthcare provider who can walk you through your results, address any questions or concerns you have, help you think through next steps, and may be able to prescribe treatment for hypothyroidism, if appropriate.

Included with your purchase, you have the ability to discuss your results with an independent healthcare provider who may be able to prescribe hypothyroidism specific treatment depending on your results.

If your thyroid (TSH) lab result is abnormal or out of expected range, the lab will perform an additional test (free thyroxine, T4) on the sample you have already provided at no extra cost to you. This additional testing can provide additional diagnostic information to help with care.

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Access results online as soon as they’re available. You will be emailed when they are ready. Discuss your results with an independent healthcare provider at no extra cost. Treatment options may be available.

Having too much or too little cortisol can affect the critical bodily functions it helps regulate. That’s why it’s crucial to understand how to check cortisol levels.

FAQs

Can this test diagnose anxiety or depression?

No, this test does not diagnose anxiety, depression, or any other mental health condition. This test looks at biomarkers that may contribute to underlying causes of anxiety or depression or that may help identify physical conditions such as iron-deficiency anemia or thyroid conditions that may have similar symptoms. Mental health conditions are diagnosed through comprehensive evaluation by a qualified healthcare professional.

Is it possible to have depression and anxiety at the same time?

Yes, it is very common. The two conditions often feed into each other, and many adults are diagnosed with both. Shared symptoms often include sleep disturbances, fatigue, irritability, and trouble concentrating.

What causes anxiety and depression?

Both disorders are typically caused by a mix of biological, genetic, and environmental factors. Common risk factors include a family history of mental disorders, prolonged exposure to high stress, and even underlying physical illnesses (like thyroid conditions or chronic pain).

Are there treatments for anxiety and depression?

Yes, both are treatable. Both anxiety disorders and depression are typically treated with psychotherapy, medication, correction of underlying medical problems driving symptoms, or a combination of all.

Why do I need a morning appointment, and do I need to fast?

This panel includes cortisol testing, which is recommended to be collected in the morning (between 7am and 9am) when levels are at their natural peak. Fasting for 8-12 hours prior to collection is recommended, as certain foods and beverages can affect results. Water is fine to drink. You should also avoid alcohol, coffee, tea, tobacco use, and strenuous exercise before your appointment.

If my results are abnormal, what happens next?

If your results fall outside expected ranges, you may receive an alert call from an independent healthcare coordinator. An independent healthcare provider will be available to discuss your results (even if they are within range) and, where appropriate, they may advise on possible next steps, however you should always discuss these results with your regular provider. For thyroid-related findings, treatment options may be available directly through the independent healthcare provider.

If this test identifies a physical contributor, will treating it resolve my anxiety or depression symptoms?

Not necessarily, but it can be an important piece of the puzzle. If a physical condition such as a thyroid disorder or nutritional deficiency is identified and treated, some symptoms may improve. However, anxiety and depression are complex conditions with multiple contributing factors, and most people benefit from a comprehensive evaluation and treatment plan with their healthcare provider. This test is intended to inform that conversation, not replace it.

Can I use this test to monitor treatment for anxiety or depression?

No. This test is not intended to diagnose, monitor, or guide treatment for anxiety, depression, or other mental health conditions. Healthcare providers may use laboratory testing to evaluate overall health or investigate possible contributing medical conditions.

What lab tests are commonly ordered for symptoms of anxiety or depression?

Healthcare providers may order laboratory tests to evaluate thyroid function, nutritional status, iron levels, and other health markers when investigating symptoms that could have both physical and mental health causes.

Can I use my FSA or HSA funds to purchase tests on questhealth.com?

You may be able to use your FSA or HSA funds to purchase lab tests at questhealth.com. Please review your FSA/HSA plan or check with a tax professional to confirm specific requirements for individual eligibility.

Are tests purchased from questhealth.com covered by my health insurance?

Tests purchased on questhealth.com are intended for individuals paying directly—we do not bill insurance, and purchases cannot be submitted for insurance reimbursement.

If your doctor ordered a lab test for you and you are looking to book an appointment for sample collection, you can schedule an appointment here https://appointment.questdiagnostics.com/as-home.

For other questions related to a lab test your doctor ordered for you, including billing and results, you can visit the main Quest Diagnostics site here https://www.questdiagnostics.com.

Our references

Forbes Health. Mental Health Statistics And Facts. Accessed May 27, 2026. https://www.forbes.com/health/mind/mental-health-statistics/
CDC National Center for Health Statistics. Mental Health. Accessed May 27, 2026. https://www.cdc.gov/nchs/fastats/mental-health.html
CDC Mental Health. Mental Health Conditions & Care. Accessed May 27, 2026. https://www.cdc.gov/mental-health/about-data/conditions-care.html
MedlinePlus. Catecholamine Tests. Accessed May 27, 2026. https://medlineplus.gov/lab-tests/catecholamine-tests/
Khalil B, Rosani A, Warrington SJ. Physiology, Catecholamines. [Updated 2024 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507716/
Mayo Clinic Health System. Identifying signs of anxiety and depression. Accessed May 27, 2026. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/addressing-your-mental-health-by-identifying-the-signs-of-anxiety-and-depression
EBSCO. Epinephrine and norepinephrine. Accessed June 11, 2026. https://www.ebsco.com/research-starters/health-and-medicine/epinephrine-and-norepinephrine

Tests purchased on questhealth.com are only for individuals who intend to pay directly for testing and do not want to submit a claim for reimbursement under their health insurance.

Mental Health (Anxiety & Depression) Contributors Test Panel