When a person tells a doctor or therapist that he or she is depressed, the first thing the clinician will do is ask questions to determine whether or not the patient is having a Major Depressive Episode (MDE).
An MDE is not an illness per se, but it will help the clinician determine what illness is affecting the patient. For example, the presence of an MDE could indicate Major Depressive Disorder. If there is a history of past manic symptoms in addition to a current MDE, a Bipolar Disorder may be diagnosed. Depressive symptoms that are not as severe as an MDE, but that have persisted for at least two years, could indicate Dysthymia, which is also a form of clinical depression.
Signs of Clinical Depression
The first sign of a Major Depressive Episode is whether or not the patient has had a depressed mood for at least two weeks. Even if the person does not feel depressed, others may have noticed that the person is excessively sad and tearful. The mood change would have to be present for most of the day nearly every day.
The next symptom test examines whether the patient has felt a loss of interest or pleasure in life and all or almost all of the daily activities, including those that were once pleasurable.
One or both of these signs of depression must have persisted for at least two weeks for an MDE to be present. The feelings must be noticeably different from how the person used to feel.
Major Depressive Episode Symptoms
In order for a Major Depressive Episode to be present, five or more of the following symptoms must have existed along with the depressed mood and/or loss of pleasure:
- a significant weight loss or weight gain;
- difficulty sleeping or too much sleeping nearly every day;
- physical movements that appear to others to be either restless and fidgety, or very slow;
- fatigue and lack of energy nearly every day;
- feelings of worthlessness and feelings of inappropriate guilt that can even be so out of touch with reality as to seem delusional;
- indecisiveness and difficulty concentrating, either noticeable by the self or others; and
- recurrent thoughts of death and thoughts of suicide, whether specific or general, or a suicide attempt (fear of death does not qualify as a symptom.)
Other Aspects of Major Depressive Episodes
If manic symptoms are simultaneously present, then this would be considered a Mixed Episode, rather than an MDE, and a Bipolar Disorder would be diagnosed. If the symptoms were due to a drug or medical condition, then it would not be considered an MDE. If the person is mourning the loss of a loved one, the symptoms would be attributed to grief, not an MDE, unless more than two months have gone by, or unless the symptoms are dominated by psychotic symptoms, suicidal thoughts, severe impairment in functioning, a morbid feeling of worthlessness, or severe physical slowing down.
The presence of a Major Depressive Episode helps clinicians determine whether or not a mood disorder, such as Major Depressive Disorder, Dysthymia, or one of the Bipolar Disorders is present. Depressive symptoms must appear in certain combinations, for specific lengths of time, and in the absence of other symptoms, in order to be considered an MDE.
This article is for information only and is not a substitute for personal, medical or mental health advice. Anyone with troubling symptoms should see a medical or mental health professional in person. Depression can be a serious illness and should not be taken lightly. Many people benefit from treatment.
Lisa C. DeLuca - Lisa C. DeLuca is a psychotherapist/social worker who works with families and teens. She also treats panic and anxiety disorders.
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