What Should I Know About DSM V Depression?
Updated February 17, 2021
Medically Reviewed By: Lori Jones, LMHC
DSM and depression are associated with one another, but they’re two very different things. Depression is a serious medical condition, while the DSM is a handbook that serves as an authoritative guide for diagnosing mental health disorders.
Diagnostic Criteria For Depression According To the DSM-5
When you visit a mental health professional, they take a medical and mental health history from you. They will ask you a lot of questions, and they may ask you to fill out one or more questionnaires. Once they’ve done their due diligence in information gathering, they’ll compare the information with the criteria for major depressive disorder as provided by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders before making a diagnosis of a depressive disorder or something else.
The DSM-5 is the latest version of the Diagnostic and Statistical Manual of Mental Disorders. According to this guide, individuals must experience five or more of the following symptoms during the same two-week period, and the symptoms should either be related to a depressed mood or loss of interest or pleasure:
- Experiencing a depressed mood almost every day for most of the day.
- Having a noticeable decreased interest or pleasure in all or almost all activities that you formerly enjoyed almost every day.
- Having a significant weight gain or loss when not consciously trying to lose or gain weight or having a noticeable decrease or increase in appetite.
- Feeling like your thoughts are sluggish and having slower physical movements.
- Feeling fatigued or loss of energy almost every day.
- Having feelings of worthlessness, excessive guilt, or misdirected guilt almost every day.
- Difficulty being able to think, concentrate or focus almost every day.
- Having recurrent thoughts of death, having recurrent suicidal ideations, having a plan for committing suicide, or attempting suicide.
If you or someone that you know is experiencing the symptoms as described in the final bullet point, it’s important to seek emergency help. The National Suicide Prevention Lifeline 1-800-273-8255 and is available 24 hours a day, 7 days a week.
In the latest version of the DSM-5, the APA added two more specifications to help further classify diagnoses.
- Depression With Mixed Features. This means that for patients that don’t meet the full criteria for a manic episode, clinicians can allow for the presence of manic symptoms as part of their diagnosis for depression.
- Depression With Anxious Stress. Clinicians should perform an assessment of anxious distress as part of their assessment for depression and determine whether it warrants any changes in their prognosis, treatment options, or patient’s response to them.
What Are the Signs And Symptoms Of Clinical Depression?
No one is immune to the symptoms of clinical depression. It can strike anyone at any time, across genders, ethnicities, socioeconomic statuses, and other demographics.
For a clinician to accurately diagnose clinical depression, the symptoms of depression must be severe enough to cause disruption in their work, school, social life, or daily activities, and they shouldn’t be caused by substance abuse or some other medical condition.
Here are some of the questions a licensed clinician may ask to determine a diagnosis of clinical depression. Some of these are also listed under the criteria for the DSM-5.
- Feeling sad, teary-eyed, empty or hopeless
- Having angry outbursts, or expressing irritability or frustration over little things
- Losing interest or pleasure in most or all normal activities like sex, sports, or hobbies
- Sleeping far too much or far too little
- Being tired, lacking energy
- Extreme weight loss or weight gain or big changes in appetite
- Feeling anxious, agitated, or restless
- Experiencing slowed speech or body movements
- Feeling guilty, worthless, or fixating on past failures
- Having difficulty thinking, concentrating and making decisions
- Frequent or consistent thoughts of suicide or death
- Physical problems like back pain or headaches that can’t be explained
Suicide Associated With Major Depression
According to the U.S. Department of Health and Human Services (HHS), the majority of people that have depression die due to a cause other than suicide. While that’s good news, people that have a diagnosis of depression have an increased risk of suicide when compared with people that don’t live with depression. In some cases, the risk of death by suicide may be related to the severity of the depression.
HHS has new data that shows that about 2% of the people that have been treated for depression in an outpatient setting will die by suicide. The rate for people living with depression that have been treated in an inpatient hospital setting is higher at 4%. Patients that were treated for depression on an in-patient basis following incidents of having suicidal ideations or suicide attempts are three times more likely (6%) to die by suicide as those who were treated in outpatient settings.
HHS also reports that there are significant differences in the risk of suicide connected with depression based on differences in gender. The rate for men with a lifetime history of depression that die by suicide is 7% as compared with only 1% of women that have a lifetime history of depression that die due to suicide.
As mentioned above, if you or someone you know are suicidal, you should seek immediate help. The National Suicide Prevention Lifeline is available at 1-800-273-8255 and is reachable 24 hours a day, 7 days a week.
Clinical depression is a serious medical condition. If you suspect that you or someone that you care about has uncontrolled depression, it helps to schedule an appointment with a licensed therapist. Treatments for depression are usually quite effective. The sooner you seek help, the sooner you can begin to enjoy life again. Remember that no matter what you’re experiencing, with the right tools, you can move forward in healthy ways.
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