Clinical depression, also known as major depressive disorder, affects over 16 million adults in the United States each year. There is, however, a distinct difference between sadness and clinical depression. Depression must be diagnosed and treated by a professional such as a psychologist or psychiatrist.
There are several criteria that are required for the diagnosis of depression. These criteria are measured either through depression scales or simply through observation and examination by your doctor. Your doctor may ask you a series of questions about your symptoms and lifestyle to determine if a diagnosis of depression is right for you. The depression criteria used are published in the DSM-5, which is the manual used for the diagnosis of mental health conditions by all professionals. Here are the depression criteria that are used for diagnosis and how they are determined.
The following depression criteria are determined by the DSM-5 and are assessed by a clinical psychologist or psychiatrist. For a diagnosis of depression, at least five of these symptoms must be present for a specified period.
Having a depressed mood most of the day nearly every day is one of the primary depression criteria in the DSM-5. A depressed mood is defined as explained or unexplained sadness that negatively impacts your life and your ability to perform day to day tasks. A depressed mood can affect your relationships, home life, and career.
People who have clinical depression have diminished interest in all or almost all activities of the day. You may have less interest in sex, hobbies, career, school, children, and other aspects of your life. Often people who have less interest in activities or take no pleasure from activities find themselves cut off from others and spend quite a bit of time alone and stagnant.
Depression can cause significant changes in weight. You may experience unexplained weight loss without dieting or changing your exercise routine or activity level. On the other hand, some people eat more when they are depressed, causing significant gains in weight. While weight changes can be a symptom of many mental or physical health problems, when combined with other depression criteria, it can be a clear sign of depression.
When you are depressed, you may mentally and physically slow down considerably. Your mind may not work as fast as it used to, and you may have difficulty completing cognitive tasks. You may also have feelings of restlessness. However, for this depression criteria to be met, the restlessness and slowing down must be visible to others, not just internal feelings.
Depression is tiring. Many people who are clinically depressed sleep excessively. If they are unable to sleep, they tend to be very tired and drag throughout the day. Chronic fatigue and constantly feeling as though you need to sleep can be a clear-cut sign of depression.
Feelings Of Worthlessness And Guilt
One of the depression criteria is feelings of worthlessness and guilt. You may feel as though you cannot do anything right, or that everyone is better off without you around. You may also frequently feel guilty for things that may or may not be within your control. Unexplained or unreasonable feelings of worthlessness and guilt can make depression worse, and it is one sign that depression has reached a severity that needs to be clinically treated.
Inability To Concentrate
Many people who have clinical depression cannot concentrate or make decisions. This is because the mind obsesses over the feelings and thoughts caused by and surrounding depression. When the mind races with thoughts of worthlessness, guilt, inadequacy, and anxiety, it can make it impossible to concentrate on cognitive tasks. Memory can also fail.
Suicidal ideation is different than suicidal thoughts. People who are depressed often think about death frequently and may have ideas that suicide would be the perfect solution. However, these people are not necessarily in danger of committing suicide. However, some people with severe depression do have suicidal tendencies and should be watched closely.
Frequency And Duration
For a diagnosis of depression to be made, at least five of the above eight depression criteria must be present every day or most days of a period of at least two weeks or more. Most people who are diagnosed with depression have experienced these depression criteria for much longer than two weeks, especially if they have waited to seek treatment.
The DSM-5 also allows for associated features of depression. Although these are not necessarily criteria, these features are frequently found in the process of diagnosis of depression. The first of these is a high mortality rate. Patients who are diagnosed with or undergoing treatment for depression must be watched carefully by professionals, caregivers, spouses, and parents for warning signs of suicide.
Other associated features are essentially symptoms that many people with depression exhibit. Although these are not depression criteria for diagnosis, these associated symptoms can be an indicator of depression or the severity of depression. These symptoms include irritability, brooding, obsessive rumination, anxiety, phobias, and excessive worry over health.
The DSM-5 has some new specifiers that help continue to narrow down the diagnosis. These specifiers are additional diagnoses that further describe the patient's condition. The first of these is "with mixed features," which simply means that the clinical depression episode has some features of mania, but not enough features of mania to constitute a diagnosis of bipolar or mania.
The second of these specifiers is "with anxious distress," and refers to people who have clinical depression accompanied by severe anxiety. Severe anxiety and phobias can make treatment of depression more difficult, and these features need to be considered when developing a treatment plan, especially psychotherapy approaches.
Getting A Diagnosis
These depression criteria are used by clinicians, psychologists, and psychiatrists to determine if someone has clinical depression. Many different depression scales can be used to determine if the depression criteria are being met for an accurate diagnosis. The most common depression scale that is used for this purpose is the Hamilton Depression Rating Scale.
The HDRS can also be used to determine the severity of depression. According to a publication with the National Institute of Health, many doctors fail to use these depression scales. However, when they are used, they have a clear indication of the severity of depression. This is important for both diagnosis and developing a treatment plan. The depression scales are also important for measuring the success of treatment and the severity of symptoms over time.
Your Next Steps
If you are reading this and are recognizing the depression criteria in your thoughts, feelings, and behaviors, you must seek help as quickly as possible. Leaving depression undiagnosed and untreated can greatly negatively impact your life in several ways. Relationships, your career, and your family can all get affected. Also, untreated depression can lead to additional mental and physical health problems.
Your first step is to talk to a professional that will be able to examine depression criteria and give you an accurate diagnosis. From there, you can get resources for treatment, both with medications and psychotherapy. Some people opt for therapy alone because they do not want to take medications. While this does work for some people, it is important not to rule out medication as a treatment option entirely.
You can go about this in several ways. Your primary care doctor may be able to administer the depression scale and determine if you need to see a psychologist or psychiatrist for further diagnosis or treatment. If you are certain that you need help, you can contact your health insurance company to determine what professionals are covered in your area under your plan.
If you do not have health insurance, or you have other barriers to getting help, there are some other options. Online counseling can be very effective for the diagnosis and treatment of depression, and it is much more accessible for many people. The cost of online counseling is much lower than the cost of therapy and treatment at a brick and mortar clinic or doctor. It can also be more convenient and easier to work around your busy schedule.
BetterHelp is one of the services that offer online counseling. You can connect with a licensed therapist on BetterHelp's platform so that you can get an accurate diagnosis of depression using the depression criteria. BetterHelp therapists are available all hours of the day and night, seven days a week, sometimes even on holidays. You can have your therapy sessions through BetterHelp anywhere that you have a smartphone, tablet, or laptop and an internet connection. You have the options of voice chat, video chat, or text chat, either by phone or the online platform. With so much convenience and accessibility, there is no reason to put off getting an accurate diagnosis and starting treatment.