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The information below will outline the diagnostic criteria for the different types of depression.

Diagnosis of major depressive disorder

This is the standard category of depression typically used to diagnose patients. In order to be diagnosed with major depression, a person must have at least 5 of the following 9 symptoms over a period of at least 2 weeks, with at least one of these symptoms being a depressed mood:

  • A depressed mood for most of the day, especially in the morning.

  • A markedly diminished interest or pleasure in most activities nearly every day, as self-reported or observed by others.

  • Significant weight loss or weight gain, defined as a change of 5% of body weight or more in a given month.

  • Insomnia (trouble sleeping) or hypersomnia (excessive sleeping) almost every day.

  • Impaired motor function, either trouble staying still or trouble moving.

  • Fatigue/loss of energy almost every day

  • Feelings of worthlessness or guilt on most days

  • Indecisiveness or trouble concentrating

  • Recurrent thoughts of death or suicide.

These symptoms cannot be explained by substance abuse, medications a patient is taking, or other medical conditions such as hypothyroidism, and do not occur in response to the death of a loved one (which is a different diagnosis of complicated grief). It also must be causing significant distress or impairment in a person’s life.

Diagnosis of persistent depressive disorder (dysthymic disorder)

Formerly labeled “depressive neurosis” in the 1950s and then “depressive personality” in the 1970s, a person meets the criteria for dysthymic disorder when they exhibit the following:

A) A depressed mood for most of the day, on more days than not, for a period of at least two years (or 1 year in children and adolescents)

B) Presence of two or more of the following symptoms on depressed days:

  • Poor appetite or overeating

  • Insomnia or hypersomnia

  • Low energy or fatigue

  • Low self-esteem

  • Poor concentration or impaired decision making

  • Feelings of hopelessness

C) The symptoms under A & B within this 2 year period (or 1 for kids and teens) have never subsided for more than 2 months at a time.

D) The symptoms cannot be explained by a medical condition, substance abuse, or a hypomanic episode (bipolar disorder).

Diagnosing Premenstrual dysphoric disorder

This is an independent category of depression marked by the following criteria:

  • At least 5 mood symptoms that are present a week before the onset of a majority of menstrual cycles in the previous year, and which then subside within a few days after the onset of menses.

  • At least one of these symptoms includes either marked affective liability (mood swings), marked irritability or interpersonal conflict, depressive mood, and marked anxiety or tension.

  • The presence of at least one of the following symptoms: anhedonia, fatigue, poor concentration, change in appetite, insomnia or hypersomnia, a sense of feeling overwhelmed or out of control, and physical aches and pains.

These symptoms must cause significant distress or disruption in the patient’s life and cannot be explained by another disorder or medical condition.

Diagnosing Substance/Medication induced depressive disorder

For this subset of depression, a patient must meet the following criteria:

A) A persistently depressed mood, impaired functioning, or anhedonia apparently caused by a substance or medication.

B) These symptoms developed during or shortly after exposure to said substance.

C) The symptoms cannot be better accounted for by another disorder and do not occur exclusively during the course of a delirium.

Diagnosing depression in men

Depression in men could be under-diagnosed because of “our culturally defined definitions of depression.” (Cochran, 2001, p. 232) Men can be prone to exhibiting symptoms that don’t fit within the diagnostic criteria for depression, including things such as alcohol and drug abuse, antisocial behavior, increases in conflict, expressions of anger, withdrawal, and defensive assertions of their autonomy. (ibid) The underlying feelings of depression could be exactly the same, but if men express this sadness in ways that come off as angry or antisocial rather than sad, they’re not going to be flagged for depression in the same way that women would.

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