Depression according to the DSM-IV
Depression is a well-known problem. Many people have an opinion on whether you are depressed or not. One could say that you are definitely depressed while another believes that you are just going through a rough time. But is there a way to decide precisely when you are depressed? Yes: psychiatrists use the DSM to diagnose disorders. The newest version, the DSM 5, dates back to May 2013. As this version is not yet used widely, we use the criteria of the DSM-IV in this article.
What is the DSM?
The DSM is a manual for diagnostics and statistics. It was written by the American Psychiatric Association. In this manual, it is written which disorders exist, how common they are, and what criteria need to be fulfilled in order for someone to be diagnosed. The disorders are divided up into categories, which are handled worldwide. Per disorder, the following elements are represented: which symptoms one needs to have and how many symptoms one needs to have before there can be a disorder diagnosed. The DSM is used by both psychologists and psychiatrists. It needs to be said, however, that only psychiatrists are allowed to diagnose.
Depression according to the DSM-IV
To be able to speak of a depressed episode or major depression, the DSM-IV states the following criteria which need to be fulfilled:
A. During a period of two consecutive weeks, at least one of the following elements must be present: unhappy mood or loss of general interest or contentment. On top of this, at least 5 of the symptoms below must be present for a period of at least two consecutive weeks.
- Showing a clearly depressed mood for the larger part of the day. This must be shown from either subjective reports or through observation by others.
- A clear loss of interest or enjoyment in all or nearly all activities during the larger part of the day. This must be shown from either subjective reports or observation by others.
- A clear loss or gain of weight and a change in appetite without dieting.
- More or less sleep than normal, sleeplessness and a disrupted sleeping pattern.
- Psychomotor agitation or slowing nearly every day. This must be visible to others.
- Tiredness or loss of energy, nearly every day.
- Feelings of worthlessness or extreme unwarranted feelings of guilt, nearly every day.
- Lessened ability to think or focus or indecisiveness nearly every day. This must be subjectively reported or observed by others.
- Recurrent thoughts of death, recurrent suicidal ideation, or a suicide attempt or a specific plan to commit suicide.
B. The symptoms do not comply with the criteria for a mixed episode.
C. The symptoms cause a significant clinical suffering or hinder social, work-related and/or other important fields.
D. The symptoms are not the cause of the effects of drug or medication use nor caused by a somatic (physical) illness.
E. The symptoms cannot be explained by grief, for example after the loss of a loved one. These symptoms can last more than two months.
Severity of depression according tot he DSM-IV
The severity of a depression can be decided with the help of the amount of symptoms present. The more symptoms are present, the more severe the depression is. The DSM-IV has the following criteria for this:
- If one criterion is met, “symptom depression” is indicated.
- If two to four criteria are met, minor depression is indicated.
- If four to nine criteria are met, major depression is indicated.
Keep in mind that the amount of suffering has the largest influence on the severity of a depression. This is understood as subjective suffering. This means that your opinion counts. If you indicate that you suffer severely, a major depression is indicated. If not, a minor depression can be indicated.
Treatment of depression: online self-help
Every type of depression needs a different approach. Often, a combination of antidepressants and cognitive behavioral therapy works best. With the help of cognitive behavioral therapy (CBT) patients learn to think differently. We try to break out of the negative vicious cycle.
’15Minutes4Me.com is an online self-help program which is partially based on cognitive behavioral therapy. With this self-help program you work on yourself for 15 minutes per day. During these 15 minutes you receive solution focused questions and videos which will make you think about what works for you. This program mainly focuses on minor depression and symptoms of depression. It could, however, complement psychotherapy in major depressions. In research it has namely been found that 40% feel happier after 3 weeks of following ’15Minutes4Me.com’.
To check whether or not you are depressed, ’15Minutes4Me.com’ has developed a free online depression test. After filling out this test, you will get a page with an indication of your depression right away. With the help of arrows, the severity of your depression will be presented.