What is the medical definition of depression?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, depression is a mental disorder characterized by persistently low mood and loss of interest or pleasure in most activities. These core symptoms must last for at least two weeks to meet the diagnostic criteria for a depressive episode.
Here are the medical criteria outlined in the DSM-5 for major depressive disorder (clinical depression):
1. Presence of five (or more) of the following symptoms during the same two-week period and represent a change from previous functioning; at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure:
- Depressed mood most of the time, nearly every day, as indicated by either subjective report (e.g., feelings of sadness, hopelessness, emptiness, or tearfulness) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
- Markedly diminished interest or pleasure in all, or almost all, activities most of the time, nearly every day (as indicated by either subjective account or observation).
- 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.)
- Insomnia or hypersomnia nearly every day.
- Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
- Diminished ability to think or concentrate or indecisiveness, nearly every day (either by subjective account or as observed by others)
- 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.
2. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
3. The depressive episode is not better explained by a psychotic disorder, bipolar disorder, or another depressive disorder superimposed on another medical condition, substance abuse, or medication.
It's essential for a thorough psychiatric evaluation to ensure an accurate diagnosis, rule out other potential causes of the symptoms, and determine the severity of the condition. Treatment strategies can vary depending on individual circumstances and are typically a combination of therapy and/or medication.