MAJOR DEPRESSIVE DISORDER*

Five (or more) of the following  symptoms  during the same two-week period, and at least one of the symptoms is either

(A) depressed mood or

(B) loss of interest or pleasure in most activities

 List of Symptoms

(1) Depressed mood most of the day, nearly every day

[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

(3) Significant weight loss when not dieting, or weight gain

[Note: In children, consider failure to make expected weight gains]

(4) Insomnia, or oversleeping, nearly every day.

(5) Agitation, or lethargy, nearly every day

(6) Fatigue or loss of energy nearly every day.

(7) Feelings of worthlessness or excessive or inappropriate guilt

(8) Diminished ability to think or concentrate, or indecisiveness

(9) Recurrent suicidal thoughts, a plan to commit suicide, or an attempted suicide

[Note: There must not have been any manic episodes]

 *Adapted from: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 356.

 DYSTHYMIC DISORDER 

This is a more moderate, chronic form of depression which encompasses the following characteristics*:

A. There must be depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years.

B. There must be present, while depressed, two (or more) of the following:

(1) Poor appetite or overeating

(2) Insomnia or over-sleeping

(3) Low energy or fatigue

(4) Low self esteem

(5) Poor concentration or difficulty making decisions

(6) Feelings of hopelessness

C. There must not have been any Major Depressive Episode(s)

D. There must not have been any Manic Episode

E. The symptoms must not be due to the direct effect of a substance or a medical condition

F. The symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

*Adapted from: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 381.