It can be hard to recognize depression. Especially if you don’t know precisely what the symptoms are. It also doesn’t help that depression and sadness can be hard to distinguish from each other, especially to the untrained eye.

It’s a disease that’s on the rise in the entire world for various reasons.

If you are wondering whether you’re depressed or not, then the DSM-5 criteria can guide you towards a general idea. But beware, only a healthcare professional can properly and officially diagnose you.

Depression is typically officially diagnosed by a mental health professional, such as a psychiatrist or psychologist.

That’s done through a combination of methods like interviews, standardized assessments, and observations.

Here’s how the process generally works:

1. Clinical interview

• • The professional will talk with the individual about their symptoms, which may include persistent sadness, lack of interest in usual activities, fatigue, sleep changes, changes in appetite, and feelings of guilt or worthlessness.

They’ll discuss how long these symptoms have been present, how intense they are, and how much they affect daily functioning.

They’ll review medical history, family history of mental health issues, and any potential stressors or life events that might be contributing factors to these psychological difficulties.

2. Standardized questionnaires

• • Structured tools such as the PHQ-9 (Patient Health Questionnaire-9) or Beck Depression Inventory (BDI) can help measure how severe a person’s symptoms are.

These surveys provide a score indicating symptom severity and can assist the clinician in deciding if the criteria for depression are met.

3. Diagnostic criteria (DSM-5)

• • The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) is typically used to assess if an individual meets the criteria for a major depressive disorder (MDD) or another depressive disorder in the United States.

For a verdict of MDD, symptoms should persist most of the day, nearly every day, for at least two weeks, and include at least five of the DSM-5-specified symptoms, such as depressed mood, loss of interest, sleep problems, and low energy.

4. Differentiating from other conditions

• • The physician will rule out other possible causes of symptoms, such as other mental health disorders (e.g., anxiety disorders, bipolar disorder) or medical conditions like thyroid disorders or vitamin deficiencies.

They may refer the individual for lab tests or consult with other healthcare providers to rule out physical health causes if needed.

5. Assessing functional impairment

• • Depression is also assessed based on how much it impairs an individual’s daily life, relationships, and responsibilities. This includes work and social life.

Several other tools and techniques can aid in diagnosing depression in addition to the typical clinical interviews, questionnaires, and diagnostic criteria.

Although these are not as widely used for making a primary diagnosis, they can still help support or confirm a diagnosis, especially in complex cases.

Here are some additional approaches:

6. Self-reported symptom tracking
   
   

• • Tools like mood diaries or apps (e.g., Moodpath, Daylio) allow individuals to record their symptoms over time. These logs can be extremely valuable since they may reveal symptom patterns, triggers, and even the effectiveness of treatments. All these things can provide helpful information for doctors.

7. Neuroimaging and brain Scans

• • Neuroimaging is not used in routine clinical practice, but research has shown that people with depression regularly show specific patterns in brain activity, especially in areas like the prefrontal cortex and amygdala. Functional MRI (fMRI) and PET scans are being explored in research to improve our understanding of the biological underpinnings of depression. Hopefully, these advances in modern healthcare may one day assist in making an easier and more accurate diagnosis.

8. Genetic testing

• • In cases where treatment resistance is an issue, genetic testing can provide insights into how an individual may metabolize certain antidepressants. Although not a diagnostic tool, it helps to personalize treatment by predicting how a person will respond to certain medications.

9. Blood tests for biomarkers (experimental)

• • There is research going on to identify biological markers of depression, such as inflammation markers, cortisol levels, and BDNF (brain-derived neurotrophic factors). Blood tests for these biomarkers are not part of routine practice yet, since it’s still experimental, but may be used in research settings.

10. Electroencephalogram (EEG)

• • EEGs are sometimes used in research, but in some cases, in clinical settings as well, to observe brain wave activity patterns that may be associated with depression. EEG-based tests like PEER (psychiatric EEG evaluation registry) give information that can help in predicting a person’s response to treatment.

11. Behavioral and cognitive testing

• • Some clinicians like to use tests that measure cognitive function (e.g., memory, attention) and reaction times to identify cognitive changes that often accompany depression. Cognitive symptoms such as reduced concentration and slowed thinking can be diagnostic clues.

12. Observations by family members or friends

• • Loved ones often notice changes that the average individual may not see. This information is critical to doctors as it brings a broader view of symptoms and their impact on daily functioning, especially in cases where the affected person may underreport or be unaware of their symptoms.

13. Biopsychosocial assessments

• • Physicians may evaluate the social and environmental factors affecting a person’s mood. Think of components like trauma history, lifestyle, relationships, and job stress. Understanding these aspects helps to determine how much external factors may be contributing to depressive symptoms. While these methods alone aren’t enough to diagnose depression, they add depth and context, contributing to a more accurate and comprehensive diagnosis. As such, it’s still useful to use them in conjunction with the primary methods to diagnose whether someone is depressed or not.

DSM-V depression criteria

DSM-5 outlines the following criteria to make the diagnosis of depression:

• The individual must be experiencing five or more symptoms during the same 2-week period, and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.
• A minor depressive episode is characterized by 2–4 symptoms during the same 2-week period, and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.
• To receive the diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.

Primary DSM-5 depression disorders: criteria for adults

Depressive diagnoses:	Symptoms:
Major depressive episode: 5 or more depressive symptoms for ≥ 2 weeks. Must have either a depressed mood or loss of interest/pleasure. Symptoms must cause significant distress or impairment. No manic or hypomanic behavior. Minor depressive episode:* 2–4 depressive symptoms for ≥2 weeks. Must have either a depressed mood or loss of interest or pleasure. Symptoms must cause significant distress or impairment. No manic or hypomanic behavior.	Depressed mood most of the day, nearly every day. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. Significant weight loss when not dieting, or weight gain, or a decrease/increase in appetite nearly every day. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down). Fatigue or loss of energy nearly every day. Feelings of worthlessness or excessive or inappropriate guilt nearly every day. Diminished ability to think or concentrate, or indecisiveness, nearly every day. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt, or a specific plan for committing suicide.
Dysthymic disorder: Depressed mood for most of the time for at least two years. Presence of 2 or more symptoms of dysthymia. Never without symptoms for 2 months or more over 2 years. Symptoms must cause clinically significant distress or impairment. No major depressive disorder in the first two years, no manic, hypomanic, or mixed episodes.	Significant weight loss (or poor appetite) or weight gain. Insomnia or hypersomnia. Fatigue or loss of energy. Low self-esteem. Diminished ability to think or concentrate, or indecisiveness. Feelings of hopelessness.

*Not a formal diagnosis, but considered a research category requiring further study.

What does the DSM-5 stand for?

DSM stands for “Diagnostic and Statistical Manual of Mental Disorders”. The V stands for the fifth edition of said handbook.

In other words, it is a scientifically based classification system for mental and emotional disorders like depression, eating disorders, obsessive-compulsive personality disorders, and many other illnesses.

It is used as a diagnostic tool for mental health assessments to determine if someone is suffering from a psychological disorder or not.

Various healthcare professionals from all over the world, such as psychotherapists, clinicians, and psychiatrists, employ this tool to determine if someone is suffering from a mental disorder or not.

Can you self-diagnose depression?

Self-diagnosing depression can be difficult and risky because depression is a complex mental health condition with symptoms that can vary from person to person. However, there are self-assessment tools, such as questionnaires and online screenings, that can help identify potential symptoms that you might be suffering from depression or another mental disorder. Still, they cannot replace a professional evaluation since they’re educated to administer these tests.

These self-evaluation tools are not intended to provide a formal diagnosis, but can give you a general sense of whether you should seek professional help. Here are a few of the most used models and tests:

1. PHQ-9 (Patient Health Questionnaire-9)

• • Purpose: Measures the severity of depression based on the nine criteria used in diagnosing major depression.
  • How it works: You rate the frequency of symptoms such as sadness, fatigue, changes in sleep or appetite, and feelings of hopelessness over the past two weeks. Each symptom is scored from 0 (“not at all”) to 3 (“nearly every day”).
  • Scoring: Scores range from 0 to 27, with higher scores indicating more severe depression.
    • 0-4: Minimal depression.
    • 5-9: Mild depression.
    • 10-14: Moderate depression.
    • 15-19: Moderately severe depression.
    • 20-27: Severe depression.

2. Beck Depression Inventory (BDI)

• • Purpose: Assesses the intensity of depression.
  • How it works: Consists of 21 multiple-choice questions that cover mood, behavior, and physical symptoms.
  • Scoring: Each question is scored from 0 to 3, leading to a total score between 0 and 63.
    • 0-13: Minimal depression.
    • 14-19: Mild depression.
    • 20-28: Moderate depression.
    • 29-63: Severe depression.

3. Zung Self-Rating Depression Scale (SDS)

• • Purpose: Measures the severity of depression symptoms.
  • How it works: A 20-item self-report questionnaire that covers cognitive, emotional, and physiological symptoms of depression. Each item is rated on a scale from 1 (“a little of the time”) to 4 (“most of the time”).
  • Scoring: The scores are converted into an index, which classifies depression as:
    • 25-49: Normal.
    • 50-59: Mild depression.
    • 60-69: Moderate to marked depression.
    • 70 and above: Severe depression.

4. Hamilton Depression Rating Scale (HAM-D)

• • Purpose: Used in clinical settings but can be administered in a simplified version for self-assessment.
  • How it works: Evaluates mood, feelings of guilt, insomnia, agitation, anxiety, weight loss, and somatic symptoms. It’s more often used by clinicians but can be found in online self-assessment forms.
  • Scoring: Higher scores indicate more severe depression.

5. Center for Epidemiologic Studies Depression Scale (CES-D)

• • Purpose: A screening tool for depression in the general population.
  • How it works: A 20-item scale designed to measure depressive symptoms in the past week.
  • Scoring: Scores range from 0 to 60. A score of 16 or higher suggests the need for further evaluation.

Limitations of self-diagnosis tools:

While self-diagnosing can be an accessible and convenient way of examining yourself, it does have some potential key downsides.

• Screening, not diagnosis: These tools can suggest that you might have depression, but they cannot replace a clinical evaluation.
• Lack of context: A clinician can consider your personal history, lifestyle, and other factors that a test cannot assess.
• Risk of misinterpretation: It’s easy to misunderstand or over-interpret the results, especially if you’re distressed.

If you score in a range that suggests moderate or severe depression, then it’s recommended to seek the aid of a professional mental healthcare provider. These examinations can be a helpful first step to figuring out if something is wrong, but depression should always be diagnosed by a professional. They can also help by providing you with the appropriate individual treatment and guidance throughout the whole process.

Conclusion

The DSM-5 can be used as an effective diagnostic tool by health professionals to determine if someone is suffering from a mental illness or not.

However, it’s typically too complex for most untrained individuals to be used as a self-test tool with absolute certainty. Still, it can provide you with some general idea of whether you’re suffering from depression or not.

Make sure to seek help from a professional, as well as close friends and family, if you suspect that you’re currently suffering from depression or another mental illness! It’s a battle that you don’t have to fight alone. I have sought assistance from others before when I was suffering, and I can honestly say that it helped me a lot!