9 Depression Criteria Used For Diagnosis

Updated December 5, 2022by BetterHelp Editorial Team

In 2020, experts estimate that 14.8 million adults in the U.S. had at least one major depressive episode that led to notable impairment.

There is 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 may be measured either through depression scales or 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 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.

Are You Or A Loved One Experiencing Depression?

Depression Criteria

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.

Depressed Mood

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.

Diminished Interest

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 may spend quite a bit of time alone and stagnant.

Weight Changes

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, potentially 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.

Slowing Down

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 can be incredibly tiring. Many people who are clinically depressed sleep excessively. If they are unable to sleep, they tend to feel 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 may need to be clinically treated.

Inability To Concentrate

Many people who have clinical depression might not be able to concentrate or make decisions. This is likely 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. There also may be memory fails.

Are You Or A Loved One Experiencing Depression?

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 for 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.

Associated Features

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.

If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 988, and is available 24/7.

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.

New Specifiers

The DSM-5 has some new specifiers that can help continue to narrow down the diagnosis. These specifiers are additional diagnoses that can 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 through psychotherapy approaches.

Getting A Diagnosis

These depression criteria can be 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 can offer a clear indication of the severity of depression. This can be particularly important for both diagnosis and developing a treatment plan. The depression scales can also be important for measuring the success of treatment and the severity of symptoms over time.

Your Next Steps

If you 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 be affected. Also, untreated depression can lead to additional mental and physical health problems.

Your first step can be to talk to a professional who 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/or psychotherapy. 

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.

Another accessible option is online therapy. Online counseling can be very effective for the diagnosis and treatment of depression, and it is much more convenient 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.

Clinical studies have proven, over and over and over again, that online therapy is just as effective as in-person therapy when it comes to treating the symptoms of depression. Online therapy methods can greatly reduce the psychological distress that comes along with depression symptoms and offer relief to the people who need it most.

BetterHelp is one of the services that offer online counseling. You can connect with a licensed therapist on BetterHelp's platform for 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 efficacy, there is no reason to put off getting an accurate diagnosis and starting treatment.


Diagnosing depression is not based on a feeling or opinion, but rather a specific, accepted, research-based clinical process. Only a certified medical professional can offer an accurate diagnosis based on your symptoms and experiences, and receiving a diagnosis is critical to moving past your symptoms to enjoy a healthy and peaceful life. 

If you or a loved one is experiencing symptoms of depression, please promptly reach out to BetterHelp or otherwise contact a licensed therapist or clinician.  

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