Major Depressive Disorder

Major depressive disorder (MDD) is diagnosed when someone has at least five symptoms all day and nearly every day for at least two weeks. One of these symptoms needs to be a depressed mood or loss of interest in activities. However, for children and adolescents, the mood might be irritable instead.

The symptoms of MDD that are in the diagnostic criteria include:

  • Depressed mood (or irritability in children and adolescents)
  • Decreased interest or pleasure in daily activities (anhedonia) 
  • Weight loss or gain, or a noticeable change in appetite
  • Difficulty sleeping or sleeping more than usual
  • Noticeable changes in physical movements, as in moving very slowly or being more restless and agitated
  • Fatigue or loss of energy 
  • Feeling worthless or inappropriately guilty 
  • Difficulty thinking and concentrating
  • Thoughts of death or suicide.

Atypical Depression

Atypical depression is a specifier (depression with features that are not typical) added to the diagnosis of MDD. It is assigned when certain signs and symptoms are present a majority of the time during a major depressive episode. One of the features is mood reactivity, meaning someone’s mood brightens in response to positive events. Atypical depression also presents with at least two of the following features:

  • Significant increase in appetite or weight gain 
  • Sleeping too much (hypersomnia) 
  • Heavy feelings in arms and legs (leaden paralysis) 
  • Consistent pattern of sensitivity to interpersonal rejection, which causes impairment

Persistent Depressive Disorder

Persistent depressive disorder (PDD) is also known as dysthymia. It is characterized by a depressed mood that is present for most of the day, most days, for at least two years (or for one year in children and adolescents). They must have two or more specific symptoms in addition to the depressed mood. These are:

  • Decreased appetite or overeating 
  • Insomnia or sleeping more than usual 
  • Low energy 
  • Low self-esteem 
  • Difficulty concentrating or making decisions
  • Feeling hopeless


Perinatal Depression

Perinatal depression is a mood disorder that occurs before or after a child’s birth.

Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder (PMDD) is a condition characterized by severe irritability, lability (shifting moods), depression, or anxiety during the one to two weeks prior to the beginning of menstruation. The symptoms tend to resolve about two to three days after the period begins.

Symptoms of PMDD can include:

Irritability or anger 
Sadness, feelings of despair, or thoughts of suicide
Tension or anxiety 
Panic attacks 
Mood swings
Loss of interest in daily activities 
Difficulty thinking or focusing 
Fatigue or low energy 
Food cravings or binge eating 
Difficulty sleeping 
Feeling a loss of control
Cramps, bloating, breast tenderness, headaches, joint or muscle pain

Bipolar Depression Symptoms

During a depressive episode, an individual may experience the following symptoms:

  • Crying for no reason or prolonged periods of sadness
  • Difficulty concentrating or indecisiveness
  • Extreme fatigue, including the inability to get out of bed
  • Feelings of guilt or hopelessness
  • Loss of interest in activities that usually give you pleasure
  • Loss of interest in health, nutrition, or physical appearance
  • Sleeping excessively or difficulty sleeping
  • Suicidal thoughts or an impulse to self-harm
  • Problems with cognitive skills, such as subjective memory trouble, difficulty concentrating, and indecision, can be the first things noticed by others when someone has bipolar depression.

Seasonal Affective Disorder

Seasonal affective disorder (SAD) is a form of depression in which symptoms occur and recur seasonally. It is formally known as major depressive disorder with seasonal pattern. Symptoms include ones that may happen with major depressive disorder, but there are some that are specific to each pattern of SAD, whether occurring in winter or summer. For example, oversleeping (hypersomnia) is sometimes present in SAD occurring in the winter, while difficulty sleeping (insomnia) sometimes occurs in summer-pattern SAD.


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