Depression, Depression Types

Major Depressive Episode

The essential feature in a Major Depressive episode is a period of time of at-least 2 weeks with either a depressed mood or a loss of interest in much of or all activities.

The individual must also experience at least four additional symptoms drawn from a list that includes loss of appetite or weight or sleep, decreased energy, feelings of worthlessness or guilt, difficulty thinking, concentrating, trouble making decisions, or recurrent thought of death and suicide.

People are often described as being “down in the dumps”, hopeless and depressed.

One thing to note with MDE is that it comes as an abbreviated phase, compared to perhaps MDD (Major Depressive Disorder), which is long-term phase, and could last the entire life of the person.

A common duration for these episodes can last as long as 6+ months according to some research, and can be gone rather abruptly in as little as a few weeks. (Albeit the person seeks help and learns to cope with what has caused their distress.)

Criteria For Major Depressive Episode

A. Five or more of the symptoms have been present for at-least 2 weeks and represent a change in previous functioning. One of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

(1) depressed mood most of the day, nearly every day, as indicated by a subjective report or observation made by others

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day

(3) significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day

(4) insomnia or hypersomnia nearly all day

(5) psychomotor agitation

(6) fatigue or loss of energy nearly every day (7) diminished ability to think or concentrate

(8) feelings of worthlessness or guilt

(9) recurrent thoughts of death


In the DSM, there is a section in the Mood Disorder section that is called specifiers.

Specifiers for Mood Disorders are provided to increase diagnostic specificity and create more homogeneous subgroups, assist in treatment selection, and improve the prediction of prognosis. The Severity/Psychotic/Remission specifiers describe the current clinical status of the Mood Disorder.

Mild:

Few, if any symptoms in excess of those required to make the diagnosis and symptoms result in only minor impairment in occupational functioning or a usual social activities or relationships with others.

Moderate:

Symptoms or functional impairment between mild and severe.

Severe Without Psychotic Features:

Several symptoms in excess of those required to make diagnosis, and symptoms markedly interfere with occupational functioning or with usual social activities with others.

Severe With Psychotic Features:

Delusions or hallucinations. If possible specify whether the psychotic dentures are mood-congruent or mood-incongruent.

Mood-Congruent Psychotic Features:

Delusions or hallucinations whose content is entirely consistent with the typical depressive themes of person inadequacy, guilt, disease, death, nihilism, or deserved punishment.

Mood-Incongruent Psychotic Features:

Delusions or hallucinations whose content does not involve typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. Included are such symptoms as persecutory delusions, thought insertion, though broadcasting, and delusions of control.

In Partial Remission:

Symptoms of a Major Depressive Episode are present but full criteria are not met, or there is a period without ant significant symptoms of a Major Depressive Episode less than 2 months following the end of the Major Depressive Episode.

In Full Remission:

During the past 2 months, no significant signs or symptoms of the disturbance were present.