Understanding The DSM 5 Depression Criteria

Reviewed by Wendy Boring-Bray, DBH, LPC

Published 12/09/2020

If you have depression or think that you might, it's likely that you have a couple questions about depression, whether those are related to depression treatments available, how to understand the criteria with which depression is diagnosed or the different types of depressive disorders. Medical and mental health professionals use the diagnostic and statistical manual of mental disorders, frequently referred to as the DSM, to diagnose mental health conditions. The most recent version of the DSM is the DSM-5. There have been some changes in the diagnostic and statistical manual over the years as each new edition is published. So what is depression, and how can you better understand the DSM-5 depression criteria?

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What Is Depression?

Depression is a mental health condition. It is more than just sadness. Sadness is valid, and it's something that we all experience, but the two terms aren't interchangeable. Depression symptoms can be so severe that they impact an individual's ability to function and perform daily tasks. In the DSM-5, there are a number of different recognized depressive disorders. These disorders include Disruptive Mood Dysregulation Disorder, Major Depressive Disorder (MDD), Persistent Depressive Disorder, Premenstrual Dysphoric Disorder, Substance/Medication-Induced Depressive Disorder, Depressive Disorder Due to Another Medical Condition, Other Specified Depressive Disorder, and Unspecified Depressive Disorder. Each disorder has specific criteria listed in the diagnostic and statistical manual. This is so that medical and mental health professionals can provide you with an accurate diagnosis.

Some symptoms of depressive disorders may include:

  • Low or depressed mood
  • Loss of interest in the activities the individual used to enjoy
  • Sleeping too much or too little
  • Difficulty focusing on concentrating
  • Fatigue or restlessness
  • Appetite changes
  • Feelings of worthlessness or hopelessness
  • Excessive crying or numbness

Depression can range from mild to severe. Depressive disorders are common. The American Psychological Association or APA notes that 6.7% of people aged 18 or older will be impacted by depression annually. Additionally, 16.6% of individuals will experience depression at some point in their lives. Depression can occur in people of all ages. On top of the 6.7% of adults experiencing depression, the Center For Disease Control or CDC says that 3.7% of individuals aged 3-17 have been diagnosed with depression. A depression diagnosis is serious at all ages, and it is a treatable condition. It's necessary to note that there are times when depressive symptoms may be attributed to another condition or health concern. This is one reason why seeking a diagnosis from a medical or mental health professional and ruling out other potential causes for your symptoms is important.

DSM-5 Criteria For Depression

The diagnostic criteria for each depressive disorder differ. Here's a digestible overview of the diagnostic criteria for MDD or major depressive disorder in the DSM-5. To be diagnosed with major depressive disorder or MDD, five out of the following nine criteria must be met simultaneously during a two week time period. These symptoms must be a change from an individual's preceding way of functioning, and at least one symptom must be a depressed mood or loss of pleasure or interest in activities one used to enjoy.

  • Depressed mood or low mood for most of the day on a nearly daily basis
  • Loss of interest in activities one used to enjoy for most of the day on a nearly daily basis
  • Weight or appetite changes without any other cause
  • Trouble sleeping (whether that's insomnia, sleeping too little, or hypersomnia, sleeping too much)
  • Feelings of hopelessness, disproportionate guilt, or worthlessness
  • Change in activity/psychomotor agitation
  • Trouble concentrating or focusing
  • Fatigue
  • Suicidality (If you have been experiencing any suicidal thoughts, reach out for help immediately. You can reach the National Suicide Prevention Lifeline at 1-800-273-8255, 24 hours a day, 7 days a week).

Additionally, for a diagnosis, the following must be true:

  • Depressive symptoms cause clinically significant distress or impairment in social, occupational (school, work, etc.), or other important areas of functioning
  • There is no history of a manic or hypomanic episode (this is not applicable if all manic or hypomanic episodes were produced by substance use or attributed to the consequences of another medical condition)
  • One's episodes aren't more accurately attributed to substance use or another medical condition
  • One's episodes aren't better explained by schizoaffective disorder, schizophrenia, or any other specified and unspecified schizophrenia spectrum disorders or other psychotic disorders

Depression vs. Bipolar Disorder

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You'll notice that in the DSM criteria above, it's noted that, for a diagnosis of Major Depressive Disorder to occur, a mixed or manic episode must not have transpired. Bipolar disorder is a mood disorder that is characterized by periods of mania or hypomania and depression. If someone has depressive episodes and manic or hypomanic episodes, they would be more likely to meet the criteria for bipolar disorder or a related disorder instead of depression. To receive a depression diagnosis, contact your doctor or reach out to a psychiatrist. Screening for depression is generally very noninvasive and is conducted by a medical or mental health professional who can diagnose and treat mental disorders who will ask you a series of questions and provide you with an evaluation and diagnosis based on your answers. In some cases, your general practitioner may diagnose you with depression, or you may see a psychiatrist for a diagnosis.

DSM-5 Depression Code

The DSM-5 code varies depending on what type of depressive disorder is being diagnosed. Here are some of the codes listed in the DSM under depressive disorders:

F34.8 Disruptive Mood Dysregulation Disorder

F34.1 Persistent Depressive Disorder (also known as Dysthymia)

N94.3 Premenstrual Dysphoric Disorder

F32.8 Other Specified Depressive Disorder

F32.9 Unspecified Depressive Disorder

F33.0    Major depressive disorder (recurrent, mild)

F33.1    Major depressive disorder (recurrent, moderate)

F33.2    Major depressive disorder (recurrent, severe without psychotic features)

F33.3    Major depressive disorder (recurrent, severe with psychotic features)

F33.40  Major depressive disorder (recurrent, in remission, unspecified)

F33.41  Major depressive disorder (recurrent, in partial remission)

F33.42  Major depressive disorder (recurrent, in full remission)

Substance or Medication-Induced Depressive Disorder and Depressive Disorder Due to Another Medical Condition are also recognized in the DSM-5. Comorbid mental health conditions are common in those with depressive disorders. A comorbid condition is a condition that occurs at the same time as another condition. For example, someone with depression may also have anxiety, substance use disorder, or an eating disorder. You can have more than one mental health condition.

Risk Factors For Depression

There are a number of risk factors that may increase the likelihood of someone developing a depressive disorder. These risk factors include a family history of depression or another mental health condition, personal history of a physical or mental health condition, such as chronic pain or substance use disorder, major life stressors or trauma, and even gender. Statistically, women are more likely to experience depression than men are. Still, depression can occur and someone of any gender, with 7.2% of women and 4.3% of men experiencing major depressive disorder. It's also important to note that transgender people are at a higher risk for depressive disorders and that gender dysphoria can contribute to depression. The onset of depression can occur at any time, but the average age range for onset is late teens to mid-twenties. The good news about a diagnosis of depression is that, again, it is a treatable condition.

What Is The Best Depression Treatment?

Talk therapy and medication are two potential treatments for depression. Some people choose to treat depression through a combination of various treatment modalities. For all guidance regarding treatment and medication, please consult a licensed medical professional.

A common form of therapy used for depression is cognitive-behavioral therapy or CBT. Psychodynamic therapy is also popular. For some individuals, support groups are beneficial, whether those operate in person or online. You can seek therapy online or in person by finding a provider near you, looking for someone who offers remote sessions near you or going through an online therapy website. To find a therapist or counselor in your local area, you can search the web for "depression counselors near me" or "depression therapists near me." You can also contact your doctor for a referral, call your insurance company or visit their website to see what they offer, look for low-cost therapy or counseling in your area, or sign up for an online therapy website like BetterHelp where you can take a short questionnaire and get paired with a counselor or therapist who can help you. The best depression treatment will vary from person to person, so it is important to find what's right for you.

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Take The Mind Diagnostics Depression Test

After reading this article, do you think that you might live with a depressive disorder? If so, consider taking the Mind Diagnostics depression test. It isn't a replacement for a diagnosis of depression, but it can give you some insight into what you may be experiencing. After taking the mind diagnostics depression test, you can have your results sent to you via email immediately. The test is free, fast, and confidential. If you have depression, you are not alone, and support is out there.

Click here to take the Mind Diagnostics Depression test, and feel free to use the search tool on our website to look for a provider if you are looking for someone to talk to.