FAQ

Depression

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.  

Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.

Dysthymic Disorder

This disorder is characterized by an overwhelming yet chronic state of depression, exhibited by a depressed mood for most of the days, for more days than not, for at least 2 years. (In children and adolescents, mood can be irritable and duration must be at least 1 year.) The person who suffers from this disorder must not have gone for more than 2 months without experiencing two or more of the following symptoms:

• poor appetite or overeating

• insomnia or hypersomnia

• low energy or fatigue

• low self-esteem

• poor concentration or difficulty making decisions

• feelings of hopelessness

No Major Depressive Episode has been present during the first two years (or one year in children and adolescents) and there has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode, and criteria have never been met for Cyclothymic Disorder.

The symptoms are not due to the direct physiological effects of a the use or abuse of a substance (alcohol, drugs, medications) or a general medical condition. The symptoms must also cause significant distress or impairment in social, occupational, educational or other important areas of functioning.  

Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.