MDD: DSM Criteria for Major Depressive Disorder

Major depressive disorder (MDD) is a mental illness defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM provides the diagnostic criteria used by doctors for major depressive disorder (MDD) and all mental disorder diagnoses.

MDD Symptoms

The DSM major depressive disorder (MDD) diagnostic criteria require the occurrence of one or more major depressive episodes. Symptoms of a major depressive episode include the following:¹

• Depressed mood
• Anhedonia (diminished loss of interest or pleasure in almost all activities)
• Significant weight or appetite disturbance (read more about: Depression and Weight Gain, Weight Loss)
• Sleep disturbance
• Psychomotor agitation or retardation (a speeding or slowing of muscle movement)
• Loss of energy or fatigue
• Feelings of worthlessness (low self-esteem)
• Diminished ability to think, concentrate and make decisions
• Recurrent thoughts of death, dying or suicide
• Longstanding interpersonal rejection ideation (ie. others would be better off without me); specific suicide plan; suicide attempt

Additional DSM Major Depressive Disorder (MDD) Criteria

In MDD, the DSM states either a depressed mood or anhedonia must be present. In addition to the above DSM criteria for a major depressive episode, the episode must:

• Be at least two weeks long
• Cause significant distress or severely impact social, occupational or other important life areas
• Not be precipitated by drug use
• Not meet the criteria for another mental disorder like schizophrenia or bipolar disorder
• Not be better explained by bereavement (such as the loss experienced after a death)

Major depressive disorder can be rated mild, moderate or severe. The DSM also recognizes MDD may occur with psychotic symptoms. When the MDD continues for more than two years, the DSM labels it chronic depression or dysthymia.

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