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What are the DSM 5 diagnostic criteria for major depressive disorder?
- A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
- 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful)
- 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation)
- 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day
- 4. Insomnia or hypersomnia nearly every day
- 5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
- 6. Fatigue or loss of energy nearly every day
- 7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
- 8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
- 9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
- B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- C. The episode is not attributable to the physiological effects of a substance or to another medical condition.
- D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
- E. There has never been a manic episode or a hypomanic episode.
Five or more of the following symptoms must be present nearly every day
during a 2-wk period:
Core symptoms (>/= 1 required for diagnosis)
- Depressed mood most of the day
- Anhedonia or markedly decreased interest or pleasure in almost all activities
Specify if:
- With anxious distress
- With mixed features
- With melancholic features
- With atypical features
- With mood-congruent psychotic features
- With mood-incongruent psychotic features
- With catatonia
- With peripartum onset
- With seasonal pattern (previously called seasonal affective disorder)
Additional symptoms
- Clinically significant weight loss or increase or decrease in appetite
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished ability to think or concentrate, or indecisiveness
- Recurrent thoughts of death or suicidal ideation
Major depressive disorder (MDD), also known as clinical depression or major depression, is a mental health condition characterized by persistent feelings of sadness, loss of interest or pleasure in activities, and a range of emotional, cognitive, and physical symptoms. It is a common and serious mood disorder that can significantly impact daily functioning and quality of life.
To receive a diagnosis of major depressive disorder, these symptoms must persist for at least two weeks and significantly impair daily functioning.
To be diagnosed with Major Depressive Disorder, these symptoms must be present nearly every day for at least two weeks and cause significant distress or impairment in daily functioning.
Causes of Major Depressive Disorder can be complex and involve a combination of genetic, biological, environmental, and psychological factors. Common risk factors for depression include a family history of depression, certain medical conditions, life stressors, trauma, and substance abuse.
Treatment for Major Depressive Disorder usually involves a combination of psychotherapy, medication, and lifestyle changes:
- Psychotherapy: Cognitive-behavioral therapy (CBT), interpersonal therapy, and other forms of talk therapy can help individuals learn coping skills, identify negative thought patterns, and develop healthier ways of thinking and behaving.
- Medication: Antidepressant medications may be prescribed to help alleviate symptoms of depression. There are different classes of antidepressants, and the choice of medication depends on individual needs and response.
- Lifestyle Changes: Regular exercise, a balanced diet, and sufficient sleep can support overall well-being and may help improve depressive symptoms.
- Support System: Having a strong support system of family and friends can be beneficial in managing depression.
It’s essential to seek professional help if you or someone you know is experiencing symptoms of depression. Depression is a treatable condition, and early intervention can lead to better outcomes and improved quality of life. A mental health professional, such as a psychiatrist or psychologist, can provide a comprehensive assessment and develop an appropriate treatment plan based on individual needs.
Treatment for major depressive disorder typically involves a combination of psychotherapy, medication, and lifestyle changes. Psychotherapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT), helps individuals identify and change negative thought patterns and develop healthy coping strategies.
Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), may be prescribed to help alleviate symptoms. Lifestyle changes, including regular exercise, healthy sleep habits, and social support, are also important in managing depression.
Convergent evidence from international studies indicates that Major Depressive Disorder (MDD) is one of the most common mental disorders affecting adult populations.
In addition to being a highly disabling disorder, MDD is also a risk factor for several other NCDs (e.g., cardiovascular disease) and has been demonstrated to complicate health outcomes from conditions ranging from cardiovascular disease and diabetes to obesity.
Major depressive disorder (MDD) has been ranked as the third cause of the burden of disease worldwide in 2008 by WHO, which has projected that this disease will rank first by 2030.
Within the broader category of “non-communicable” chronic diseases (i.e., NCDs), MDD is associated with relatively higher rates of disability (e.g., impairment in role function) when compared to most other NCDs (e.g., diabetes mellitus) and is also associated with premature mortality of up to 10 years of potential years of life lost.
Summary
- Major Depressive Disorder (MDD), commonly known as depression, is a mood disorder characterized by persistent feelings of sadness, loss of interest or pleasure in most activities, and a range of emotional and physical symptoms. It is a serious mental health condition that can significantly impair daily functioning and quality of life.
Symptoms of Major Depressive Disorder may include:
- Persistent Sadness: Feeling sad, empty, or hopeless most of the day, nearly every day.
- Loss of Interest: Diminished interest or pleasure in activities that were once enjoyable, including hobbies, social interactions, and sex.
- Changes in Sleep Patterns: Insomnia (difficulty falling or staying asleep) or hypersomnia (excessive sleeping).
- Changes in Appetite or Weight: Significant weight loss or gain, or changes in appetite.
- Fatigue: Feeling tired and having low energy levels, even after minor activities.
- Feelings of Worthlessness or Guilt: Feeling worthless, excessively guilty, or self-critical.
- Difficulty Concentrating: Trouble focusing, making decisions, or remembering things.
- Psychomotor Agitation or Retardation: Restlessness or slowed movement and speech.
- Suicidal Thoughts: Recurrent thoughts of death or suicide, or suicide attempts.
