- An important factor of determining a clinical depression is the presence of certain symptoms. According to the Diagnostic Statistical Manual for Mental Health (DSM-IV TR) that mental health professionals use, a major Depressive Episode must last at least two weeks. At minimum, one symptom must either be depressed mood or loss of interest or pleasure. These are described as feelings of emptiness or sadness most of the day via self-reporting or observation by others. Five of nine other symptoms must also be diagnosed. They include: significant non-diet weight loss, insomnia or hypersomnia almost daily, twitchiness or lack of movement, worthlessness, diminished ability to concentrate or recurrent thoughts of death. A Major Depressive Disorder diagnosis can occur if at least one of these episodes occurs or two episodes within two consecutive months. Symptoms must also cause significant impact on otherwise normal lifestyle.
- Excluding certain conditions or disorders must also accompany the symptoms for a diagnosis. Depression symptoms cannot follow significant life events such as death in the family to be considered an episode. They must also not meet Mixed Episode criteria, which involve having both manic and depressive symptoms at once. If symptoms also follow substance abuse or a medical condition like hyperthyroidism, they may not be characterized as clinical depression. For a Major Depression Disorder, the depression symptoms must not be part of other previously diagnosed conditions such as Schizophrenia, Delusional Disorder, Schizoaffective Disorder or Psychological Disorder Not Otherwise Specified.
- Medication is almost always a treatment option. For adults, anti-depressants may be prescribed in order to lift the general mood. This usually works by increasing the amount of mood-affecting neurotransmitters such as serotonin or dopamine. Certain anti-depressants are not prescribed to children because they tend to increase suicidal ideation. Psychotherapy can also accompany treatment. Therapists may take a psychodynamic approach that addresses possible family history triggers for depression. They may also consider cognitive behavioral therapy approaches to help patients manage clinical depression symptoms by changing thought patterns and reactions.
