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Major Depressive Disorder Diagnosis and Symptoms
 Major
Depressive Disorder, Depressive Disorder Not Otherwise Specified, and Dysthymic
Disorder all belong to a group of clinical conditions characterized by
depressive symptoms. Major Depressive Disorder and the other depression related
diagnoses specifically do not include mania and bipolar episodes and are not due
to substance abuse, medications or other medical conditions. A diagnosis of
Major Depressive Disorder requires episodes of depression which last at least
two weeks. The following information will help you identify a Major Depressive
Disorder Diagnosis.
Major Depressive Disorder Diagnosis:
A Major Depressive Disorder diagnosis first requires
recognition of the existence of depressive symptoms and a Depressive Episode.
Depressive disorders are frequently identified and include a lifelong
vulnerability to the disease involving a low or depressed mood or loss of
interest or pleasure in an individual’s normal activities. The diagnosis of the
Major Depressive Episode requires the presence of a low mood or loss of interest
and pleasure in an individual’s activities for two weeks or more accompanied by
at least four other symptoms of depression (See
Major Depressive Episode Diagnostic Criteria).
However, individual manifestations of depression can be very different from
individual to individual and may not be easy to differentiate, which is why
professional diagnosis is always required. One or more depressive episodes
without a lifetime history of mania, hypomania or psychotic symptoms may
indicate the existence of Major Depressive Disorder. When an individual has had
only one major depressive episode it is given the subtype of "single episode". (See
Major Depressive Disorder Single Episode criteria).
A person who has experienced multiple depressive episodes over their lifetime is
given the subtype of "recurrent". (See Major Depressive Disorder Recurrent
criteria) In order to be in remission, it is required that the full criteria for
Major Depressive Episode not be met for a two-month period of time. In addition
to the criteria, it is important to understand for a clinical syndrome to exist
you must have indications of significant impairment in various psychosocial
aspects of an individual’s life including work and academic functioning and/or
psychological distress.
Major Depressive Disorder symptoms and presentation:
The presentation of major depressive disorder symptoms is frequently different
for different individuals. One individual may experience sadness while another
may not. One individual may describe significant psychological pain while
another may not be able to identify any feelings at all. An important factor
related to the experience of depression is an individual’s loss of interest and
pleasure in their normal activities. Some experts believe this key "loss of
pleasure in normal activities" symptom may be related to a reduction or general
lowering of energy, manifesting in alterations in sleep patterns, lessened
appetite for food and sexual activity.
This change in the physiology of the body frequently leads to profound feelings
of agitation and/or lethargy or constant fatigue referred to as psychomotor
retardation. Psychomotor retardation is frequently referred to by depressed
individuals as "a slow dragging feeling". On the other hand, some major
depressive episodes result in significant agitation in which an individual has
trouble sitting still for long and may even experience profound pacing. These
physiological changes also may result in difficulty sleeping and eating.
Additional common complaints frequently heard from depressed individuals is that
they have difficulty focusing their attention, concentrating and making
decisions. Some may experience a loss of memory which can be very significant in
that it may even stimulate dementia. This difficulty in concentrating may be
experienced in the performance of both minor and major tasks. Memory
difficulties in children may make it difficult for them to perform in school
while in older individuals it may even be mistaken for a primary dementia. Also,
in older individuals experiencing a depressive episode, these memory
difficulties may also occur in the early stages of a developing dementia.
Finally, a particularly disturbing indication of a probable Major Depressive
Disorder or a Major Depressive Episode includes thoughts of death or suicide.
Suicide is usually associated with feelings of hopelessness. If there is any
indication of an individual’s feeling hopeless or suicidal, a complete suicide
risk assessment should be completed. A diagnosis of Major Depressive Disorder is
always a significant and distressing event in an individual's life, which should
result in an assessment by a licensed mental health clinician.
Next: Assessment of Major Depressive Disorder
Information adapted from DSM-IV-TR Mental Disorders by Michael First and Allan
Tasman: Webpage by
Paul Susic
MA
Licensed Psychologist Ph.D. Candidate
(Health and Geriatric Psychologist)
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