Major Depression
According to the DSM-IV, mood disturbance consists of two symptoms: (1) depressed mood (feeling sad, blue, or down in the dumps), also known as dysphoria, and (2) lack of interest or pleasure in almost all activities most of the day, also known as anhedonia.
To be diagnosed with major depression, a person must experience at least five depressive symptoms from the following list, including at least one of the two hallmark features of depression—depressed mood and loss of interest. These symptoms must be present most of the day nearly every day for at least two weeks:
- depressed mood
- loss of interest
- significant weight loss or gain
- trouble sleeping or sleeping too much
- restless feelings and inability to sit still or slowed down
- fatigue, loss of energy, or tired all the time
- worthless or guilty feelings
- impaired concentration and difficulty making decisions
- recurrent thoughts of death or suicide
To be classified as indicative of major depression, these symptoms must cause significant distress or impairment in social, occupational, and other important areas of functioning. Furthermore, the formal diagnosis must rule out other medical causes of depressed mood, including medication effects, substance abuse, or general (i.e., other than psychiatric) medical condition such as hypothyroidism. Finally, the symptoms should be distinguished from those of grief or bereavement associated with loss of a loved one or extraordinary distress.
