51.1 Major Depressive Disorder

Major depressive disorder occurs when at least five signs of depression last two or more weeks (TABLE 51.1). The symptoms must cause near-daily distress or impairment and not be attributable to substance use or another medical or mental illness.

Table 51.1
Diagnosing Major Depressive Disorder
The DSM-5 classifies major depressive disorder as the presence of at least five of the following symptoms over a two-week period of time minimally including depressed mood or reduced interest (American Psychiatric Association, 2013).

To sense what major depression feels like, suggest some clinicians, imagine combining the anguish of grief with the sluggishness of bad jet lag. If stress-related anxiety is a “crackling, menacing brushfire,” noted biologist Robert Sapolsky (2003), “depression is a suffocating heavy blanket thrown on top of it.”

Adults diagnosed with persistent depressive disorder (also called dysthymia) experience a mildly depressed mood more often than not for two years or more (American Psychiatric Association, 2013). They also display at least two of the following symptoms: