What Should I Know About Depression In The DSM-5?

Depression refers to a group of depressive disorders, including major depressive disorder (MDD), which people often refer to when discussing depression. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a diagnostic manual that psychologists and psychiatrists use to diagnose mental illness. There are eight depressive disorder diagnoses in the DSM-5.

Diagnostic criteria for MDD according to the DSM-5

Major depressive disorder is a mental health condition that may also be called clinical depression. While depression is a mental health disorder, it can also cause physical symptoms like chronic pain or digestive challenges.  

Depression may manifest differently for each person, although many symptoms are the same. In some people, depression is mild; in others, it can be long-term and severe. Depending on the circumstances surrounding depression, it can be temporary or persistent. 

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 be related to a depressed mood or loss of interest or pleasure:

• A depressed mood almost every day for most of the day
• A noticeable decreased interest or pleasure in all or almost all activities that you formerly enjoyed 
• Significant weight gain or loss or a noticeable decrease or increase in appetite
• Sluggish or slow thoughts and slower physical movements
• Fatigue or loss of energy 
• Sleep disturbances: sleeping too much or too little
• Feelings of worthlessness, excessive guilt, or misdirected guilt 
• Difficulty being able to think, concentrate, or focus 
• Recurrent thoughts of death, recurrent suicidal ideations, having a plan for committing suicide, or suicide attempts 

The DSM-5 also clarifies that symptoms must cause clinically significant distress or impairment in important areas of functioning. Someone with depression may have clinically significant distress at work, around friends, or in other important areas of their life.

What is the DSM-5? 

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a diagnostic manual published by the American Psychiatric Association (APA). Healthcare providers in the United States rely on the DSM as an authoritative guide for diagnosing mental health disorders. 

In the manual, clinicians find descriptions of mental health disorders alongside symptoms and other criteria to assist them in making qualified diagnoses. The book uses common language for clinicians to use with clients and other clinicians, providing consistency in diagnostics and research. Using a common language also helps pharmaceutical companies in the development of medications and other interventions.

Am I depressed or sad? 

It can be normal to go through periods of sadness at times. However, prolonged sadness can be a symptom of depression. It can be challenging to differentiate between regular periods of sadness and mental illness. 

Often, depression occurs without cause. A person, event, or situation doesn’t cause the sadness associated with depression in many cases. Furthermore, regular periods of sadness often won’t keep you up at night or prevent you from going to work in the morning. You might still feel like eating and not feel the weight of a sense of guilt or worthlessness.

If you’re feeling sad and hopeless without cause, it could be a warning sign of depression. If you have major depressive disorder, you can also lose interest in the activities you once enjoyed. You may not feel like eating, and you might be sleeping too much or too little. A depressive disorder may cause you to have negative thought patterns about yourself and others and feel like you’re constantly in distress.

How is depression diagnosed? 

When you visit a mental health professional, they may take your medical and mental health history. They might also ask you to fill out one or more questionnaires. Once they’ve done their due diligence in gathering information, they can compare the information with the criteria for major depressive disorder provided by the American Psychiatric Association before diagnosing a depressive disorder. 

Not all providers prefer to diagnose clients. Some may work with you to tackle all symptoms regardless of cause and help you get started on focusing on the moment and the lifestyle changes you can make today. However, look for a therapist or provider that fits your life philosophy and makes you comfortable with their approach. 

What are the warning signs of major depressive disorder? 

Major depressive disorder can affect anyone 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 disrupt their work, school, social life, or daily activities and shouldn’t be caused by substance use or a medical condition. Someone with depression will not just feel occasionally sad and anxious; distress will shadow just about everything they do in their lives.

Here are some of the symptoms a licensed clinician may look for to determine a diagnosis of clinical depression:

• Sadness or hopelessness
• Apathy 
• Anger, irritability, or frustration 
• A loss of interest or pleasure in most or all activities, like sex, sports, or hobbies
• Insomnia or hypersomnia 
• Fatigue 
• Changes in appetite 
• Anxiety, agitation, or restlessness 
• Slowed speech or body movements
• Feeling unable to complete personal care tasks
• Guilt, worthlessness, or fixation on past failures 
• Difficulty thinking, concentrating, and making decisions
• Frequent or consistent thoughts of suicide or death
• Physical symptoms like back pain or headaches that can’t be explained

Counseling options 

Although depression can involve severe symptoms, it is a highly treatable condition. Many people reach out for support from a therapist, and therapy can be one of the most effective forms of treatment. However, some people with depression can face barriers to treatment, such as difficulty getting out of bed or impairment in social situations. 

Recent studies in the field of mental health have investigated the potential effectiveness of online therapy for depression. The results are promising. One such study confirmed that internet-based counseling is associated with positive outcomes for individuals experiencing depression and those with anxiety. These results may be similar to those for in-person counseling. 

Clinical depression is a serious medical condition. If you suspect that you or someone you care about is experiencing depression, it may be helpful to schedule an appointment with an online therapist through a platform like BetterHelp. With an online platform, you can attend therapy from a comfortable location like your bed or couch through phone, video, or live chat sessions.