Symptoms
A person who suffers from a major depressive disorder must either
have a depressed mood or a loss of interest or pleasure in daily
activities consistently for at least a 2 week period. This mood
must represent a change from the person's normal mood; social,
occupational, educational or other important functioning must
also be negatively impaired by the change in mood. A depressed
mood caused by substances (such as drugs, alcohol, medications)
is not considered a major depressive disorder, nor is one which
is caused by a general medical condition. Major depressive disorder
cannot be diagnosed if a person has a history of manic, hypomanic,
or mixed episodes (e.g., a bipolar disorder) or if the depressed
mood is better accounted for by schizoaffective disorder and is
not superimposed on schizophrenia, a delusion or psychotic disorder.
This disorder is characterized by the presence of the majority
of these Symptoms:
depressed mood most of the day, nearly every day, as indicated
by either subjective report (e.g., feels sad or empty) or observation
made by others (e.g., appears tearful). (In children and adolescents,
this may be characterized as an irritable mood.)
markedly diminished interest or pleasure in all, or almost all,
activities most of the day, nearly every day
significant weight loss when not dieting or weight gain (e.g.,
a change of more than 5% of body weight in a month), or decrease
or increase in appetite nearly every day.
insomnia or hypersomnia nearly every day
psychomotor agitation or retardation nearly every day
fatigue or loss of energy nearly every day
feelings of worthlessness or excessive or inappropriate guilt
nearly every day
diminished ability to think or concentrate, or indecisiveness,
nearly every day
recurrent thoughts of death (not just fear of dying), recurrent
suicidal ideation without a specific plan, or a suicide attempt
or a specific plan for committing suicide
The Symptoms are not better accounted for by bereavement, i.e.,
after the loss of a loved one, the Symptoms persist for longer
than 2 months or are characterized by marked functional impairment,
morbid preoccupation with worthlessness, suicidal ideation, psychotic
Symptoms, or psychomotor retardation.
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