A person who suffers from a major depressive disorder (sometimes also referred to as clinical depression or simply depression) must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This mood must represent a change from the person’s normal mood. Social, occupational, educational or other important functioning must also be negatively impaired by the change in mood. For instance, a person who has missed work or school because of their depression, or has stopped attending classes altogether or attending usual social engagements.
A depressed mood caused by substances (such as drugs, alcohol, medications) is not considered a major depressive disorder, nor is one which is caused by a general medical condition. Major depressive disorder generally cannot be diagnosed if a person has a history of manic, hypomanic, or mixed episodes (e.g., a bipolar disorder) or if the depressed mood is better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, a delusion or psychotic disorder.
Clinical depression is characterized by the presence of the majority of these symptoms:
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful). (In children and adolescents, this may be characterized as an irritable mood.)
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- 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.
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day
- Diminished ability to think or concentrate, or indecisiveness, nearly every day
- 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
In line with updates to the major depressive disorder criteria in DSM-5, a person can suffer from a major depressive episode during a period of Bereavement, i.e., after the loss of a loved one (this is a marked change from previous DSM-IV criteria, which did not give the diagnosis of major depression if the person was grieving over a significant loss in their lives). This is with the rationale that though bereavement may induce great suffering on a person, it does not typically induce an episode of major depressive disorder. In other words, it is not normal for the symptoms of bereavement to induce marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation for two months or more. Thus, when they do occur together, the depressive symptoms and functional impairment tend to be more severe and the prognosis is worse compared with bereavement that is not accompanied by major depressive disorder. Bereavement-related depression tends to occur in persons with other vulnerabilities to depressive disorders, and recovery may be facilitated by antidepressant treatment.
This criteria has been adapted for DSM-5.
- Depression Quiz
- Overview of Depression
- General Symptoms of Depression
- Treatment Options for Depression
- Online Depression Resources
- Depression in Older Adults
- Depression in Children
- DSM Codes for Depression
Psych Central. (2014). Depression (Major Depressive Disorder) Symptoms. Psych Central. Retrieved on October 2, 2014, from http://psychcentral.com/disorders/depression-major-depressive-disorder-symptoms/
Symptom criteria summarized from:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Last reviewed: By John M. Grohol, Psy.D. on 22 Jun 2014
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