DSM IV Depression Symptoms

The Diagnostic and Statistical Manual, 4th ed., Text Revision, or DSM-IV, contains several categories of depression disorders and their diagnostic criteria, intended as guidelines for clinicians. According to “Synopsis of Psychiatry”, the most common depressive disorder is major depressive disorder (MDD), occurring in 5 to 12 percent of men and 10 to 25 percent of women. DSM-IV criteria for MDD result in a diagnosis if the symptoms “cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.” In order to be classified as MDD, the symptoms must not be caused only by the effects of medications or medical conditions. The following are DSM-IV MDD symptoms.

Major Depressive Episode

Under the DSM-IV, MDD requires that a person has had at least one major depressive episode, or MD.

Key Symptom of MD

For a MD, the person must experience a depressed mood, or loss of interest or pleasure in activities, over a two-week period.

Other MD Symptoms

Additionally four or more of the following symptoms must be present: significant weight loss or gain, too little or too much sleep, physical agitation or slowing down, fatigue or loss of energy, feelings of worthlessness or excessive guilt, lowered ability to think, concentrate or make decisions and recurrent thoughts of death or suicide.

Other Disorders

It is not considered a major depressive episode if another psychiatric disorder, like bereavement, would better account for the symptoms.

Elevated Mood

If a person has had a manic, hypomanic (very elevated moods) or mixed manic/depressed episode, she may not be diagnosed with MDD.

Additional Symptoms

MDD may be mild, moderate, severe and have psychotic features. MDD may be chronic (lasting), catatonic (person does not want to move), melancholic (sad) or postpartum. Sometimes MDD includes some unusual aspects, like the person’s limbs feeling heavy as lead.


MDD may recur an unlimited number of times, or it may not. According to “A Multidimensional Meta-Analysis,” recent research suggests a person with MD may have an average of 4 lifetime occurrences. After a person has had MD once, chances are 85 percent will recur within 10 to 15 years.

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