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How Doctors Diagnose Depression

1. Major Depressive Episode and Major Depressive Disorder

Major Depressive Disorder requires two or more major depressive episodes.

Diagnostic criteria:

Depressed mood and/or loss of interest or pleasure in life activities for at least 2 weeks and at least five of the following symptoms that cause clinically significant impairment in social, work, or other important areas of functioning almost every day

  1. Depressed mood most of the day.
  2. Diminished interest or pleasure in all or most activities.
  3. Significant unintentional weight loss or gain.
  4. Insomnia or sleeping too much.
  5. Agitation or psychomotor retardation noticed by others.
  6. Fatigue or loss of energy.
  7. Feelings of worthlessness or excessive guilt.
  8. Diminished ability to think or concentrate, or indecisiveness.
  9. Recurrent thoughts of death or suicide

2. Dysthymic Disorder

Diagnostic criteria:

Depressed mood most of the day for more days than not, for at least 2 years, and the presence of two or more of the following symptoms that cause clinically significant impairment in social, work, or other important areas of functioning:

  1. Poor appetite or overeating.
  2. Insomnia or sleeping too much.
  3. Low energy or fatigue.
  4. Low self-esteem.
  5. Poor concentration or difficulty making decisions.
  6. Feelings of hopelessness.

3. Bipolar Episode and Bipolar Disorder

Bipolar disorder is characterized by more than one bipolar episode. There are three types of bipolar disorder:

  1. Bipolar 1 Disorder, in which the primary symptom presentation is manic, or rapid (daily) cycling episodes of mania and depression.
  2. Bipolar 2 Disorder, in which the primary symptom presentation is recurrent depression accompanied by hypomanic episodes (a milder state of mania in which the symptoms are not severe enough to cause marked impairment in social or occupational functioning or need for hospitalization, but are sufficient to be observable by others).
    1. Cyclothymic Disorder, a chronic state of cycling between hypomanic and depressive episodes that do not reach the diagnostic standard for bipolar disorder.

Manic episodes are characterized by:

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary.

B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (4 if the mood is only irritable) and have been present to a significant degree:

1)     increased self-esteem or grandiosity

2)     decreased need for sleep (e.g., feels rested after only 3 hours of sleep.

3)     more talkative than usual or pressure to keep talking

4)     flight of ideas or subjective experience that thoughts are racing

5)     distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

6)     increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

7)     excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)”

Depressive episodes are characterized by symptoms described above for Major Depressive Episode.

If you or a loved one needs help learning how doctors diagnose depression, contact Jeff at (941) 586-0929

This information is from the National Center for Biotechnology Information website.