3.2 What is Depression?
Description
This article is from the Bipolar Disorder FAQ, by barry@webveranda.com (Barry Campbell) with numerous contributions by others.
3.2 What is Depression?
Criteria for Major Depressive Episode (DSM-IV, p. 327)
A. Five (or more) of the following symptoms have been present during the same
2-week period and represent a change from previous functioning; at least one
of the symptoms is either (1) depressed mood or (2) loss of interest or
pleasure.
Note: Do not include symptoms that are clearly due to a general medical
condition, or mood-incongruent delusions or hallucinations.
(1) depressed mood most of the day, nearly every day, as indicated by either
subjective report (e.g., feels sad or empty) or observation made by others
(e.g. appears tearful). Note: In children and adolescents, can be irritable
mood.
(2) markedly diminished interest or pleasure in all, or almost all, activities
most of the day, nearly every day (as indicated by either subjective account
or observation made by others)
(3) 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. Note: In children, consider failure to make expected weight
gains.
(4) insomnia or hypersomnia nearly every day
(5) psychomotor agitation or retardation nearly every day (observable by
others, not merely subjective feelings of restlessness or being slowed down)
(6) fatigue or loss of energy nearly every day
(7) feelings of worthlessness or excessive or inappropriate guilt (which may
be delusional) nearly every day (not merely self-reproach or guilt about being
sick)
(8) diminished ability to think or concentrate, or indecisiveness, nearly
every day (either by subjective account or as observed by others)
(9) 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
B. The symptoms do not meet criteria for a Mixed Episode.
C. The symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
D. The symptoms are not due to the direct physiological effects of a substance
(e.g., a drug of abuse, a medication) or a general medical condition (e.g.,
hypothyroidism).
E. The symptoms are not better accounted for by bereavement, i.e., after the
loss of a loved one, the symptoms persist for longer than 2 months or are
characterized by marked functional impairment, morbid preoccupation with
worthlessness, suicidal ideation, psychotic symptoms, or psychomotor
retardation.
Well, the APA gives us a good starting point, but it all sounds sort of
clinical. Here's a more complete list of symptoms of depression that our
readers and participants have identified:
* Reduced interest in activities (like writing FAQs)
* Indecisiveness (maybe)
* Feeling sad, unhappy, or blue (pervasive attitude that
life sucks)
* Irritability, dammit.
* Getting too much (hypersomnia) or too little (insomnia)
sleep.
* Loss of, um, what were we talking about? Oh yeah,
concentration.
* Increased or decreased appetite (my ex-mother-in-law's
cooking notwithstanding)
* Loss of self-esteem, such as my understanding that I suck.
* Decreased sexual desire.
* Problems with, whaddya call it? Oh yeah, memory.
* Despair and hopelessness
* Suicidal thoughts.
* Reduced pleasurable feelings.
* Guilt feelings, which are all my fault anyway.
* Crying uncontrollably and/or for no apparent reason.
* Feeling helpless, which I can't do anything about.
* Restlessness, especially when I can't hold still.
* Feeling disorganized (hell, look at my desk).
* Difficulty doing things (again, like finishing this FAQ)
* Lack of energy and feeling tired.
* Self-critical thoughts
* Moving and thinking slooooooowwwwwwwly.
* Feeling that one is in a stupor, or that one's head is in
a fog.
* Speeeeeeeakiiinnnnng slooooooowwwwwwwly.
* Emotional and/or physical pain.
* Hypochondriacal worries; fears or illnesses which prove to
be psychosomatic.
* Feeling dead or detached.
* Delusions of guilt or of financial poverty.
* Hallucinating.
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