Nine criteria typically used to make a depression diagnosis

According to the National Institute of Mental Health, it’s estimated that 8.4% of US adults will experience a major depressive episode in a given year. Depression is more than just occasional sadness or a passing low mood; instead, it’s a clinical mental health disorder that’s marked by specific, persistent symptoms and typically requires professional attention to treat. 

In order to determine whether a diagnosis of major depressive disorder (MDD) is appropriate for a given individual, a mental health care provider will usually compare their symptoms to those outlined in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Read on for an overview of these criteria. Remember, only a licensed healthcare provider can make an official, clinical diagnosis of a mental health condition. That said, getting familiar with the criteria for a diagnosis of major depressive disorder can help you recognize symptoms in yourself if they occur and understand when it may be time to seek treatment.

Nine key depression criteria

Depressed mood

Having a depressed mood most of the day nearly every day is one of the primary depression criteria listed in the DSM-V. A depressed mood is defined as explained or unexplained sadness that negatively impacts one’s life and one’s ability to perform day-to-day tasks. A depressed mood can affect a person’s relationships, career, and quality of life.

Diminished interest

People who are experiencing clinical depression tend to demonstrate a diminished interest in all or many daily activities, including those they used to enjoy. This may manifest as a sense of apathy toward hobbies, socializing, their career, sex, and other aspects of life they used to have no trouble motivating themselves to engage in. 

Significant weight changes

Depression can cause significant changes in weight because of its potential to impact appetite. An individual with depression may experience unexplained weight loss without dieting or changing their physical activity levels because they have little appetite or interest in food. Others may gain weight due to an increase in food intake as a method of coping with other depression symptoms.

Lethargy or restlessness

The DSM-V refers to this symptom as “psychomotor changes”. In a person experiencing depression, these may be caused by inner tension or sadness. They may find themselves increasingly restless, displaying physical signs such as unintentional, repetitive movements. Or, they may find themselves slowed down both physically and mentally. These changes must be visible to others as well, not just subjectively felt.

Low energy and/or fatigue

Many people with depression find that they have less energy than usual, sometimes regardless of their sleep schedule. Symptoms of fatigue in those with MDD may include “reduced activity, low energy, tiredness, decreased physical endurance, increased effort to do physical tasks, general weakness, heaviness, slowness or sluggishness, nonrestorative sleep, and sleepiness” according to an article published in the Innovations In Clinical Neuroscience journal.

Difficulty concentrating

Fatigue can also have mental effects, such as difficulty concentrating, making decisions, and remembering things. Trouble focusing could also be a result of the mind being occupied with thoughts of worthlessness, guilt, inadequacy, and anxiety, which can also be symptoms of depression.

Insomnia or hypersomnia

According to a 2019 paper on the topic, “sleep disturbance is the most prominent symptom in depressive patients”. It also notes that sleep and depression have a bidirectional relationship—which means that depression can cause sleep disturbances, and that sleep issues can contribute to the experience of a depressive episode. These disturbances may come in the form of insomnia, which is characterized by difficulty falling or staying asleep, or hypersomnia, which is characterized by excessive sleepiness during the day even if you’re getting enough or more than enough sleep at night.

Feelings of worthlessness and guilt

An individual may also experience a deluge of negative thoughts as part of a depressive episode, which may manifest as feelings of worthlessness or guilt. They may feel like they don’t contribute to the lives of those around them, or they may feel guilty even for things that are not within their control. These feelings may also worsen other symptoms of depression.

Suicidal thoughts or behaviors

In more severe cases of depression, an individual may also experience suicidal thoughts or behaviors. They may be prone to recurrent thoughts of death, may speak about it often, and/or may engage in plans for or behaviors related to self-harm.

If you or someone you know is experiencing suicidal thoughts or behaviors, seek help immediately. The National Suicide Prevention Lifeline can be reached 24/7 by dialing 988.

Seeking support for symptoms of depression

If you feel you’re experiencing symptoms that may qualify as major depressive disorder, the recommended course of action is typically to meet with a healthcare professional for evaluation. First, a primary care provider can conduct a physical health screening to rule out any other potential causes of your symptoms. Then, a mental health care professional can ask you about your symptoms, your health history, and/or your family health history to decide whether a diagnosis of depression may apply. 

Effective treatment for depression is available. It typically consists of some form of psychotherapy, sometimes in combination with medication. Cognitive behavioral therapy (CBT) is one commonly recommended methodology for individuals with major depressive disorder. It focuses on helping the client learn to recognize distorted thought patterns that may be causing distress and shift them in a healthier direction. A therapist can also help a client with depression develop healthy coping mechanisms for symptoms they experience.

How online therapy can help

Some people who are experiencing symptoms of depression may find it difficult to leave the house to attend in-person therapy appointments. In cases like these, virtual therapy can be a viable alternative. Research suggests that online CBT can actually be more effective than traditional, in-person sessions for treating depression, so this option may be worth considering for those who find it more convenient, accessible, or comfortable. With a virtual therapy platform like BetterHelp, you can get matched with a licensed therapist in a matter of days who can help you address your symptoms via phone, video call, and/or in-app messaging.