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Depression Not Otherwise Specified (NOS) Demystified

Reviewed by Melinda (Santa) Gladden, LCSW · December 02, 2020 ·

Depressive disorders are common mental health conditions. According to the World Health Organization or WHO, 264 million people throughout the world live with depression. Depression can be incredibly debilitating, but with treatment, symptoms can improve, and many people with depressive disorders live full, happy, and healthy lives. In reading about depression, you might have come across the term "Depressive Disorder Not Otherwise Specified" or "Depressive Disorder NOS." As a result, you might wonder, what is Depressive Disorder Not Otherwise Specified or Depressive Disorder NOS, and when is this diagnosis used? Keep reading to find out. 

What Is Depressive Disorder Not Otherwise Specified?

Depressive Disorder Not Otherwise Specified or Depressive Disorder NOS was a diagnosis presented in the fourth edition of the diagnostic and statistical manual of mental disorders or DSM. It was described in the DSM-4 as "any depressive disorder that does not meet the criteria for a specific disorder." In other words, the diagnosis of Depressive Disorder Not Otherwise Specified or Depressive Disorder NOS was used to diagnose someone who was impacted by depression significantly but didn't meet the criteria listed under other depressive disorders, such as Major Depressive Disorder or MDD, sometimes referred to as Major Depression, which is one of the most commonly seen and prevalent depressive disorders. Receiving a diagnosis of Depressive Disorder NOS did not mean that your symptoms were not severe; it just meant that your experiences could not be categorized elsewhere. To this day, in the DSM, there are diagnoses used to encompass this experience. For example, Other Specified Feeding or Eating Disorder (OSFED), formerly known as Eating Disorder Not Otherwise Specified (EDNOS), is an eating disorder diagnosis used when someone does not meet the full criteria for other eating disorders. As with Depressive Disorder NOS, that does not mean it is not serious. OSFED is regarded as a severe and deadly eating disorder, and it is the most commonly diagnosed eating disorder at this time.

In the most recent version of the diagnostic and statistical manual of mental disorders DSM under the category of depressive disorders, we see the diagnoses of Other Specified Depressive Disorder and Unspecified Depressive Disorder. Diagnoses such as Other Specified Depressive Disorder may be used for individuals who would have been diagnosed with Depressive Disorder Not Otherwise Specified or Depressive Disorder NOS in previous times. Examples of when "Other Specified Depressive Disorder" may be used as a diagnosis include instances of recurrent brief depression and a short duration depressive episode that does not meet the criteria for another depressive disorder or recurrent brief depression. Unspecified Depressive Disorder, on the other hand, is often used in settings such as emergency rooms when professionals do not have enough information about a client to make a diagnosis. However, a client is still notably impacted by their symptoms.

Depression in the DSM-5

In the most recent version of the diagnostic and statistical manual of mental disorders or DSM, which is the DSM-5, there are currently eight diagnoses listed under the category "Depressive Disorders," which appears right before "Anxiety Disorders" and right after "Bipolar and Related Disorders." The eight potential diagnoses listed under the category of depressive disorders in the DSM-5 include Disruptive Mood Dysregulation Disorder, Major Depressive Disorder, Persistent Depressive Disorder (Dysthymia), Premenstrual Dysphoric Disorder, Substance/Medication-Induced Depressive Disorder, Depressive Disorder Due to Another Medical Condition, Other Specified Depressive Disorder, and Unspecified Depressive Disorder.

Current Depressive Disorder Diagnoses and Symptoms

Here is some additional information about the depressive disorders currently in the table of contents under "depressive disorders" in the DSM.

Disruptive Mood Dysregulation Disorder (DMDD)

The diagnosis of Disruptive Mood Dysregulation Disorder is new. This diagnosis emerged with the release of the DSM-5. However, it is important for several reasons. Disruptive Mood Dysregulation Disorder or DMDD is characterized by the following two symptoms:

  • Serious and recurring temper outbursts that occur three times per week or more on average
  • Irritability or anger that persists for the majority of the day most days or daily

For a diagnosis of Disruptive Mood Dysregulation Disorder or DMDD to occur, the symptoms must not be better explained by another condition. A diagnosis of Disruptive Mood Dysregulation Disorder is used for children between the ages of 6 and 17. It can't be diagnosed in those aged 18 or above, nor can it be diagnosed in those under 6 years old. 

Major Depressive Disorder

Major Depressive Disorder or MDD is one of the most common mental health conditions. Symptoms and signs of Major Depressive Disorder or MDD may include but are not limited to:

  • Feelings of depression or low mood
  • The loss of interest in activities one would typically enjoy
  • Feelings of worthlessness, hopelessness, or disproportionate guilt
  • Hypersomnia or insomnia (sleeping too much or too little)
  • Trouble concentrating or focusing
  • Changes in appetite
  • Fatigue or tiredness
  • Excessive crying
  • Emotional numbness
  • Restlessness

In the United States alone, Major Depressive Disorder MDD affects 16.1 million people aged 18 and older. In other words, about 6.7% of those 18 or above are said to experience Major Depressive Disorder or MDD on an annual basis.

Persistent Depressive Disorder (PDD)

Persistent Depressive Disorder, or PDD, referred to as "dysthymia," is described as a chronic or long-lasting low-level form of depression. Symptoms and signs of Persistent Depressive Disorder or PDD may include but are not limited to:

  • Persistent low mood
  • Lack of interest in activities one would typically enjoy
  • Feelings of worthlessness, hopelessness, or disproportionate guilt
  • Fatigue or tiredness
  • Hypersomnia or insomnia (sleeping too much or too little)
  • Trouble concentrating or focusing

To be diagnosed with Persistent Depressive Disorder or PDD, you must experience symptoms for two years or more.

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Dysphoric Disorder or PMDD is a disorder characterized by periods of depression that occur before one's menstrual period and dissipate once it starts or soon after. Symptoms and signs of Premenstrual Dysphoric Disorder or PMDD may include but are not limited to:

  • Feelings of sadness, depression, or despair
  • Severe mood swings or shifts in mood
  • Physical symptoms of PMS, like bloating, water retention, or cramping
  • Lack of interest in relationships or activities one would typically enjoy
  • Hypersomnia or insomnia (sleeping too much or too little)
  • Anxiety, tension, or feeling keyed up or on edge.
  • Feelings of overwhelm
  • Fatigue or tiredness
  • Trouble concentrating or focusing
  • Changes in appetite
  • Irritability or agitation

Premenstrual Dysphoric Disorder or PMDD is not the same as PMS and is symptomatically more severe. According to the International Association for Premenstrual Disorders (IAPMD) website, Premenstrual Dysphoric Disorder or PMDD is seen somewhere from 5% to 10% of people of reproductive age and were assigned female at birth.

Substance/Medication-Induced Depressive Disorder

Substance/Medication-Induced Depressive Disorder is very much so what it sounds like. Substance/Medication-Induced Depressive Disorder is diagnosed in those who experience depressive symptoms and a marked change in mood due to consuming substances. Symptoms of Substance/Medication-Induced Depressive Disorder may include but are not limited to:

  • Feelings of depression
  • Fatigue or lack of energy
  • A loss of interest in activities one would typically enjoy
  • Feelings of worthlessness, hopelessness, or disproportionate guilt
  • Hypersomnia or insomnia (sleeping too much or too little)
  • Trouble concentrating or focusing
  • Changes in appetite
  • Low self-esteem
  • Irritability

For this diagnosis to occur, someone's symptoms must not be due to another disorder and must be prompted by substance consumption.

Depressive Disorder Due To another Medical Condition

Depressive Disorder Due to Another Medical Condition is more or less exactly, what it sounds like. Signs and symptoms of Depressive Disorder Due to Another Medical Condition are much like that of other depressive disorders. They will include a depressed or low mood and/or a loss of interest in activities one would typically enjoy. However, for this diagnosis to occur, it must be evident that a person's depressive symptoms are not better explained by another mental health disorder. It must be evident that someone's symptoms only started after another medical condition arose.

Other Specified Depressive Disorder

As stated above, this disorder is used to note or mark depressive symptoms that are not diagnosable under other types of depression.

Unspecified Depressive Disorder

As stated above, this disorder is used to note or mark depressive symptoms when insufficient information is available that would allow someone to provide another diagnosis.

Note that other depressive disorders exist under these categories. For example, Seasonal Affective Disorder (SAD) is diagnosed under the category of Major Depression. Still, it is distinguished that major depressive episodes occur on a seasonal basis in those with Seasonal Affective Disorder. If you are experiencing symptoms of depression, it is important to reach out to a medical or mental health provider who can help.

Take the Mind Diagnostics Depression Test

Are you wondering if you might have depression or symptoms of depression? If so, consider taking the Mind Diagnostics depression test. The Mind Diagnostics depression test is not a replacement for a diagnosis or evaluation from a medical or mental health professional, but taking it can give your insight into your symptoms, and it might just be the first step to getting the help that you need. While depressive disorders can affect individuals of all ages, the Mind Diagnostics depression test is for those aged 18 and older. The Mind Diagnostics depression test is free, fast, and confidential.

Click here to take the Mind Diagnostics depression test.

Frequently Asked Questions (FAQs)

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