Unfortunately, even today, the first signs of depression are rarely recognized correctly: This is partly due to the very unspecific and different characteristics of the early symptoms. The harbingers of depression can be pain, e.g. in the head or stomach area, lack of energy, slight irritability, reduced interest in sex, a generally depressed mood, changed sleeping behavior and reduced or increased appetite. Obviously, these are symptoms that almost everyone has had before. This is why it is so important to have a specialist examine you when these symptoms occur, especially if they extend over a longer period of time. The specialist is able to differentiate between other clinical pictures. In addition to their experience, they refer to the official diagnostic guidelines of the DSM-5 and the ICD-10, which have officially defined the exact symptoms of depression.
According to the DSM-5, depression must meet at least 5 of the following criteria for at least 2 weeks to be diagnosed as major depression:
“1) Depressive mood
2) Significantly reduced interest
3) Significant weight loss or loss of appetite
4) Insomnia / increased sleep
5) Psychomotor restlessness/slowing down
6) Fatigue/energy loss
7) Feelings of worthlessness/guilt
8) Concentration and decision problems
9) Death, suicidal thoughts or actions”
Depressive mood or diminished interest must be present to make a diagnosis.
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ICD-10 identifies the presence of a depressive episode as follows:
“In the typical mild (F32.0), moderate (F32.1) or severe (F32.2 and F32.3) episodes, the patient suffers from a depressed mood and a reduction in drive and activity. The ability to enjoy, interest and concentration are diminished. Pronounced fatigue can occur after every slight effort. Sleep is usually disturbed, appetite is reduced. Self-esteem and self-confidence are almost always impaired. Even with the light form, feelings of guilt or thoughts about one’s own worthlessness occur.
The depressed mood changes little from day to day, does not react to life circumstances and can be accompanied by so-called “somatic” symptoms such as loss of interest or loss of joy, early awakening, morning low, clear psychomotor inhibition, agitation, loss of appetite, weight loss and libido loss. Depending on the number and severity of symptoms, a depressive episode can be described as mild, moderate or severe.
Severe depressive episodes can occur with or without psychotic symptoms. They are characterized by several of the agonizing symptoms listed above. Typically there is a loss of self-esteem and feelings of worthlessness and guilt. Suicidal thoughts and actions are common, and there are usually some somatic symptoms. In a severe depressive episode with psychotic symptoms, hallucinations, delusions, psychomotor inhibition or a stupor are so severe that everyday social activities are impossible and life-threatening.”
You can see from the large number of symptoms and the different forms of depression that diagnosis is not easy, especially as many of the symptoms can also be caused by physical causes such as a malfunction of the thyroid gland. This is another reason why a thorough examination by the doctor is indispensable before you can be sure of a diagnosis.
If you want to learn how to find out if a depressive episode is likely to occur, so you can do something about it before it takes hold, our Edupression Mood Chart and Psychoeducation program can help you to do this.
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