What are the diagnostic criteria for depression? In other words, what are the “official” depression symptoms? There are two main diagnostic tools for depression. One is extremely prevalent in North America and is called the DSM-5. The other is international and is called the ICD-10. (More on those below.) Although the ICD-10 depression symptoms are similar to the DSM-5 depression symptoms, there are important differences, which are discussed below.
Sometimes people might say that they feel depressed when what they mean is that they feel sad or down in the dumps. In my article “Is depression an emotion?” I discuss the difference between the emotion of sadness and the illness of depression in more detail. However, here, we will look at the official DSM-5 and ICD-10 depression symptoms.
What are the DSM-5 and what is the ICD-10?
What is the DSM-5?
The DSM-5 is the “Diagnositic and Statistical Manual” version 5. It is often loosely referred to as the “psychiatrist’s bible” for psychiatrists in North America. It has detailed diagnostic criteria for all psychiatric illnesses. Some people love it and some people hate it, but it is an industry standard either way.
What is the ICD-10?
ICD-10 stands for International Classification of Disease, Tenth Edition. The ICD-10 is sort of the international version of the DSM-5 except it applies to all diseases, not just those of the mind. From what I understand, it is not as detailed as the DSM-5. The ICD-10 is regulated by the World Health Organization.
Many people agree that having two different manuals to diagnose psychiatric illnesses is not a very good idea. However, it is very challenging to try to merge them, so we continue to have two manuals.
ICD-10 Depression symptoms:
First, there are three key symptoms for depression according to the ICD-10:
- persistent sadness or low mood
- loss of interests or pleasure
- fatigue or low energy
If you experience at least one of these most days, most of the time, for at least two weeks, that is the main ICD-10 criterion for depression. Then the psychiatrist would ask about the following associated ICD-10 depression symptoms:
- disturbed sleep
- poor concentration or indecisiveness
- low self-confidence
- poor or increased appetite
- suicidal thoughts or acts (If you are suicidal or in crisis, please get help immediately.)
- agitation or slowing of movements
- guilt or self-blame
Those are ten symptoms in total for depression according to the ICD-10. If a person has fewer than four symptoms, they are considered to not be depressed. Mild depression is characterized by exactly four symptoms. Moderate depression is five or six symptoms. And severe depression is seven or more symptoms.
Depression Symptoms according to the DSM-5
In many respects depression symptoms according to the DSM-5 are similar to the ICD-10 depression symptoms. Here are the symptoms of major depressive disorder in the DSM-5:
- Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.
- This mood represents a change from the person’s baseline.
- Impaired function: social, occupational, educational.
- Specific symptoms, at least 5 of these 9, present nearly every day:
- Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
- Decreased interest or pleasure in most activities, most of each day
- Significant weight change (5%) or change in appetite
- Change in sleep: Insomnia or hypersomnia
- Change in activity: Psychomotor agitation or retardation
- Fatigue or loss of energy
- Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
- Concentration: diminished ability to think or concentrate, or more indecisiveness
- Suicidality: Thoughts of death or suicide, or has suicide plan (Get help immediately!)
Both the DSM-5 and ICD-10 have fairly similar criteria for diagnosing depression although those of the DSM-5 are a little more complex. However, the DSM-5 and ICD-10 are tools meant to be used mainly by professional psychiatrists. As you probably know, psychiatrists are medical doctors who have taken further specialized training in mental health.
If you recognize the symptoms of depression from either of these tools, it is unwise to just self-diagnose or self-medicate. Instead, go and see a professional. You can start with your physician or even a psychologist. If you are in crisis, please get help immediately.
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