A. |
Five (or more) of the following nine symptoms have been present during the same two-week period and represent a change from previous functioning; at least one of the symptoms is either 1) depressed mood or 2) loss of interest or pleasure. |
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1. |
Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observations made by others (e.g., appears tearful). |
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2. |
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation) |
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3. |
Significant weight loss when not dieting or weight gain (e.g., a change of more than five percent of body weight in a month), or decrease or increase in appetite nearly every day. |
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4. |
Insomnia or hypersomnia nearly every day |
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5. |
Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) |
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6. |
Fatigue or loss of energy nearly every day |
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7. |
Feelings of worthlessness or excessive or inappropriate guilt (which might be delusional) nearly every day (not merely self-reproach or guilt about being sick) |
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8. |
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by their subjective account or as observed by others) |
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9. |
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide |
B. |
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
C. |
The episode is not attributable to the direct physiological effects of a substance or to another medical condition. |