Major depressive disorder is a unipolar disorder characterized by depressed mood that is not better accounted for by substance use (drugs, alcohol, medication), a general medical condition, a mixed episode (including manic and depressive symptoms), or bereavement. Major depression can occur as a single episode or it can be recurring. At a minimum, an individual must experience five of the nine symptoms during the same two-week period, at least one of those symptoms must be depressed mood or loss of interest, and the symptoms must represent a significant change from previous functioning. It is important to remember that, like any mental health condition, major depressive disorder should only be assessed and diagnosed by a trained, licensed mental health care professional who is equipped to rule out other concurrent and differential diagnoses.
Depressed Mood
Depressed mood is assessed based on subjective report or the observations of others and includes reported feelings of sadness, emptiness or tearfulness. To meet criteria for major depressive disorder, the feelings must be present most of the day, nearly every day, over a given two-week period.
Loss of Interest
Individuals experience a loss of interest in daily activities such that they participate in their activities but get no enjoyment from them or they stop participating in them all together because they have lost the desire to do so.
Psychomotor Changes
Individuals demonstrate psychomotor agitation--feeling antsy and irritable--or psychomotor retardation--a slowing of bodily movements--during the two-week period in question.
Fatigue
Individuals feel significant loss of energy, making it difficult to complete their basic tasks.
Sleep Disturbances
Hypersomnia (sleeping an excessive number of hours each day) or insomnia (difficulty sleeping) are present most of the time. Sleep disturbances can also manifest as trouble falling asleep or trouble staying asleep characterized by frequent waking during the night.
Weight Loss or Gain
Individuals show a change in appetite accompanied by a gain or loss of more than 5 percent of their body weight during the given two-week period.
Difficulty Concentrating
Individuals demonstrate difficulty focusing their attention on the task at hand, are easily distracted or have unusual trouble making decisions.
Worthlessness and Guilt
Individuals believe to a measurable degree they are worthless, that their situation is hopeless and feel a significant amount of guilt for things they have or have not done in the past.
Suicidal Thoughts or Behavior
Individuals experience recurrent thoughts about death, thoughts about committing suicide that include the development of a plan, or suicidal gestures or attempts.
References
- Mayo Clinic: Major Depression
- All Psych
- "Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition - TR;" American Psychiatric Association; 2000
