Types
- Depressed mood for most of the day, almost every day
- Anhedonia
- Sleep disturbance (insomnia or hypersomnia)
- Feelings of guilt and unworthiness
- Reduced concentration and attention
- Reduced self-esteem and self-confidence
- Bleak and pessimistic views of future
- Pervasive loss of interest and loss of reactivity to pleasurable stimuli
- Ideas hopelessness, worthlessness, helplessness and guilt
- Reduced psychomotor activity
- Subjective poor memory
- Fatigue
- Weight change due to appetite change
- Suicidal ideation
- Impaired functioning in important areas of life (e.g. work, school)
For a diagnosis of major depressive disorder, the following two criteria must also be present: the symptoms are not due to another psychiatric disorder and there is no history of a manic or hypomanic episode.
Differential diagnosis
Major depressive disorder
- Symptoms are present for at least 2 weeks. (must include depressed mood or loss of interest)
Persistent depressive disorder (dysthymia)
- Symptoms are present for ≥ 2 years.
- Depressed mood, Poor appetite or overeating
- Insomnia or hypersomnia
- Low energy or fatigue
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
Depression with seasonal pattern
- Typically occurs in a particular season
- Symptoms are the same as those in MDD
Minor depressive disorder
- Symptoms are present for 2 weeks for < 2 years.
- 2–4 diagnostic criteria for major depressive disorder (must include depressed mood or loss of interest)
Grief
- Identifiable loss or death of a loved one
- No functional impairment
- Symptoms typically occur in waves.
- Hallucinations of deceased loved one
- No suicidal ideation
Mood disorder due to another medical condition
- Depressive symptoms are explained by organic diseases, such as:
- Hormonal imbalances
- CNS disorders
- Cancer
Substance-induced depressive disorder
- Depressive symptoms in the setting of substance use, e.g., one of the following:
- Alcohol
- Hallucinogens
- Inhalants
- Opioids
- Amphetamines
- Cocaine
Disruptive mood dysregulation disorder (DMDD)
- Symptoms are present for ≥ 12 months.
- Severe temper outbursts (verbal or behavioral) ≥ 3 times/week
- Irritability or anger in between outbursts
- Diagnosis can only be established in children less than 18 years of age