Diagnosing Depression

Clinical depression – making the diagnosis. This is Dr. Steven Andrew Davis, Speaking of Health. Sometimes we can sum someone up easily: "yes – they’re depressed". But because it’s so important to really understand the degree of depression someone has; because it should and often can be treated; there are medical criteria for depression, and, specifically, a diagnosis called "major depression."

The American Psychiatric Association publishes and updates a Diagnostic and Statistical Manual of Mental Disorders. The diagnosis of "major depression" starts with one of two key symptoms. One of these symptoms is a depressed mood which has lasted for at least two straight weeks and causes "clinically significant distress or impairment in social, occupational, or other important areas of functioning." These patients may feel down or blue often and for long periods of time.

The other linchpin symptom of depression is called "anhedonia", which is defined as "markedly diminished interest or pleasure in almost all activities most of the day, nearly every day." Things or activities they used to enjoy? They get less pleasure from them now.

In addition to at least one of these two key symptoms the diagnosis of major depression requires the presence of other symptoms, such as sleep disturbances, appetite or weight changes, decreased energy or concentration, feeling of worthlessness or suicidal thoughts. These are serious symptoms, but reminders that depression is a serious disorder and not necessarily easy to accurately diagnose.

For a copy of this script and the journal reference, see our web site, speakingofhealth.com. Speaking of Health, I’m Dr. Steven Andrew Davis, for CBS News.

Ref: Williams, JW, et al. Is this patient clinically depressed? JAMA March 6, 2002;287:1160-70. Abstracted in American Family Physician, Vol 66. August 1, 2002. Pgs. 485-490.