- [voiceover] i wannatake a minute to talk about how clinicians diagnose depression or put in different way, iwanna talk about how clinicians can separate depression from normal and appropriate emotional responses.
clinical depression test, and they do this byusing the dsm-5, which is the diagnostic and statisticmanual of mental disorders, and this manual outlines thecriteria that someone has to have in order to bediagnosed with depression.
and there are nine differentcriteria that i wanna focus on in this video. the first criteria is that theymust have the depressed mood every day for most of the day. and this has to last overan extended period of time. and whether or not someoneactually has a depressed mood is something that can bedetermined with self-report, but it can also bedetermined by observations from people around themor by the clinician.
with depression, we also expectto see a loss of interest and enjoyment in activities that they once found pleasurable. and this also must bepresent for most of the day and over an extended period of time. depression is alsoassociated with a number of cognitive symptoms. and this could include intense feelings of worthlessness and guilt,
so feeling like youwon't amount to anything or not understanding whyanyone would even wanna be friends with you. and of course this canlead them to not going out with their friends andthen feelings of guilt for not calling, and so thiscan kind of become a cycle. people with depression can also have a hard time concentrating. so they might have a hardtime focusing on the things
that they need to do, things like getting their schoolwork done. these problems withconcentration are also associated with an inability to make decisions, and this could be for big life events like choosing a college, but this indecisivenesscan also affect small, seemingly insignificant decisions, things like figuring out what to order
for dinner at a restaurant. another cognitive symptom thatindividuals with depression might have are thoughtsabout death and dying, and this could include havingan actual plan for suicide, but it can also include thinkingabout death more generally or just not wanting to be around anymore. and this next part might surprise you, but depression also has anumber of physical symptoms. it doesn't just impact peopleon a psychological level,
so there could be significantchanges in weight, and that could include eitherweight loss or weight gain. and this can go along witha corresponding increase or decrease in appetite. individuals with depressionmight also develop insomnia, so they might havetrouble getting to sleep, or they might wake upfrequently throughout the night, but it's also possiblethat they might develop the opposite problem.
they might start sleeping too much, enough that it significantlygets in the way of their day-to-day responsibilities. another physical symptomcan be psychomotor agitation or retardation, and let's breakthis one down a little bit. psychomotor agitation is an increase in unintentional movements,so this could include things like pacing around aroom or wringing your hands or tearing and picking atthe skin on your fingernails.
psychomotor retardationis generally the opposite, so this is a slowing down of movements, and i don't mean running in slow motion. it is more like aninability to get out of bed or dress oneself or shower,or maybe a person might feel completely unable to cook for themselves or to return a phone call or an email. and i really wanna beclear that this is not out of laziness.
an individual withdepression might really feel like these tasks are impossible. and individuals with these symptoms are typically pretty confused about this, and they're really angryabout this symptom, and they might feel alot of guilt about it. the last physical symptomi wanna mention is fatigue or a loss of energy orfeeling like they don't have the energy to do the tasks that they like,
much less the tasks that they have to do, the tasks that need to get done. so these are the symptomsof depression as listed in the dsm-5, but they have a few caveats. they have a few qualifiers. the first is somethingthat i mentioned earlier, but didn't really wannarepeat with every symptom, and that's that each ofthese symptoms need to last for most of the day and needto be present nearly every day,
generally for at least two weeks. another thing to note is thatsomeone doesn't need to have all nine of these symptomsin order to be diagnosed with depression. they actually need to have as few as five. but now matter how many symptoms they have and often people do have more than five, they always have to have atleast one of these first two, so they either have tohave a depressed mood
or a loss of interest inpleasurable activities or both. another criteria is that thesesymptoms must cause distress, meaning that they must disrupta person's normal functioning in some way, so maybe they're interfering with someone's work or theirgrades or their social life. and lastly, these symptomscan't have been brought on by another disorder or as aside effect of medication. one last thing that i wanna bring up is that these criteriahave changed over time,
so i've gone over a listof symptoms from the dsm-5, which is the most recent version. but prior to thepublication of that manual, we had the dsm-4. and while most of the symptomsof depression have stayed the same from the dsm-4 to the dsm-5, i want to mention one big change, and that's the bereavement exclusion. so just like we talkedabout how you can't meet
the criteria for depression ifthat depression is brought on by a different illness, it used to be that you couldn'timmediately meet the criteria for depression if thatdepression came after a significantly negative life event. so if someone felt depressedafter the death of a loved one like a parent or child or spouse, they couldn't immediatelymeet the criteria for major depressive disorder.
instead, their experiencewith grief would have to last a lot longer in orderto get the diagnosis,
and that's something that'sbeen removed from the dsm-5. and of course as our understandingof depression increases, our knowledge about how to diagnose it and how to treat it willalso to continue to evolve.