Major Depressive Disorder DSM-5-TR

What is major depressive disorder according to the DSM-5-TR?

Major depressive disorder (MDD) is a common but serious mood disorder that is characterized by a low mood and negative emotions that last for most of the day.

Individuals who struggle with MDD have persistent feelings of sadness, hopelessness, and lose interest in people and their surroundings. MDD is commonly referred to as depression.

Below are a few MDD statistics to be aware of.

  • An estimated4 percent of the United States’ adult population has experienced at least one major depressive episode.
  • The condition is more prevalent in women than in men.
  • It is three times more likely for people between the ages of 18-25 to experience depression as compared to adults 60 and over.
  • MDD frequently occurs with other medical or psychological conditions like substance abuse, anxiety, hypothyroidism and diabetes.

People who have experienced cancer, a heart attack, post-traumatic stress disorder or Parkinson’s Disease are likely to be diagnosed with MDD.

The DSM-5-TR criteria for major depressive disorder diagnosis

In order for a person to be diagnosed with MDD, five or more of the symptoms below need to be present for at least 2 weeks continuously.

  • A depressed mood most of the day, everyday. The person may use phrases like, “I feel sad” or “I feel like I’ve lost all hope”. Sometimes, they may not verbalize these thoughts, but a family member or friend may have noticed that they are more tearful than usual or look sad.
  • A loss of interest in almost all or all activities is an important indicator of MDD. For instance, the individual may lose interest in interacting with people they care about.
  • Weight loss or a loss of appetite. A greater than 5% weight loss is a reason to be concerned especially if the person is also displaying some of the other symptoms on this list.
  • A person with MDD may experience insomnia (a lack of sleep) or hypersomnia (increased sleep). Usually both are deviations from the person’s norm.
  • “I feel tired all the time” is a comment to look out for.
  • Feelings of worthlessness and inappropriate self-guilt.These may be delusional.
  • Suicidal thoughts. The individual may or may not have a plan on how to commit suicide. They may also have attempted suicide before. This symptom makes depression particularly life-threatening.
  • A reduced ability to think, focus or concentrate.
  • The affected individual may also display anxious restlessness that is typically not related to any event going on. This is also called psychomotor agitation.
  • Psychomotor retardation may also be present. This is the opposite of psychomotor agitation. With this symptom, the individual’s thoughts are slowed, they move less or slowly and their cognitive function is also slowed (sluggish?). This symptom is common with individuals experiencing MDD with melancholic features.

In addition to the person displaying five or more of the symptoms above for at least two weeks, according to the DSM V TR. A person needs only have one major depressive episode for a doctor to diagnose them with major depressive disorder. In addition, the following criteria must be met.

  • The symptoms above must have a significant impact on the individual’s daily functioning for instance, in their social life or with their work.
  • The symptoms above must not be related to any other medical condition that the individual has or the physiological effects of a substance such as the side effects of a medication they are on.
  • There must have never been a manic or hypomanic episode.
  • The symptoms must not be explained by the presence of another condition on the schizophrenia spectrum or other psychotic disorders.

Once a person meets the above criteria, a psychiatrist can diagnose them with MDD.

Updates: The 2022 DSM-V-TR

In 2022, the American Psychiatric Association released an update to the DSM-V, known as the DSM-V-TR. While there were few changes made to the major depressive disorder category, there are a few further definitions that help

It’s also possible for a person with another disorder, such as schizophrenia or delusional disorder, to experience a major depressive episode, even though major depressive symptoms aren’t part of the condition’s diagnostic criteria.

According to the DSM-V-TR, the episode is not due to the other disorder, but instead is “superimposed” on the disorder. This means the disorder itself does not cause or explain a major depressive episode, but the person has experienced one for a separate reason.

If you’re interested in more DSM-5-TR Guided Film Previews, Symptom Media provides a free trial that you can redeem now.

Written by Gertrude Nonterah, Ph.D., RN