Major Depression: DSM-V Criteria, Symptoms, Causes And Treatment

Major depression is part of the so-called mood disorders, in which a constant feeling of sadness, of low spirits, of lack of motivation to carry out those activities in which you previously enjoyed appears reflected. These feelings affect the entire set of our feelings, thoughts and behaviors, which produces a interference in all areas of our lives such as personal, work and/or relational.

Major depression is not considered simply a temporary sadness, which can improve from one day to the next, in the vast majority of cases. requires treatment In the long term, however, don’t worry, in most cases it is reversible.

In order to classify a depressive disorder as a major depressive disorder, the DSM-V proposes the criteria that must be taken into account for its diagnosis. The DSM-V criteria for major depression are:

1. In order to determine the onset of a major depressive disorder, five (or more) of the following symptoms must appear at the same time During two weeks representing a change in the person’s way of functioning that can be seen in a depressed state of mind, or in the loss of interest in things, motivation or pleasure:

• A depressed mood should be seen for much of the day, almost every day.
• There is a decrease in interest in the activities that used to generate this emotion, for almost the entire day, most days.
• Weight loss or gain occurs.
• Changes in sleep habits, such as insomnia or hypersomnia, almost every day.
• Oneself and one’s environment observe greater agitation or psychomotor decline, almost every day.
• The person feels fatigued and/or lacks energy almost every day.
• Excessive feelings of guilt and worthlessness appear.
• Difficulty maintaining concentration or making decisions.
• Thoughts related to death appear recurrently, which can be suicidal ideations without a specific plan to carry it out, suicide attempts or previous meditations to carry out suicide.

The following criteria must also be met:

1. The appearance of symptoms generates high discomfort that generates deterioration in the different areas in which the person is, such as work or social.
2. Symptoms cannot be related to substance use, a physiological effect, or a medical illness.
3. The depressive episode is not best consistent with a diagnosis of schizoaffective disorder, schizophrenia, schizophreniform disorder, a delusional disorder, or any other disorder not otherwise specified among the psychotic disorders.
4. There has never been a manic or hypomanic episode.

Let’s take a closer look at the symptoms that appear in major depressive disorder, which can be divided into psychological, physical, behavioral, intellectual or cognitive and social symptoms, being the following:

1. Psychological: The person experiences a constant feeling of sadness, accompanied by excessive feelings of guilt or worthlessness. Thoughts linked to death appear, which manifest themselves with recurrent suicidal ideations, with or without a plan to achieve them, and there may be suicide attempts or consensual suicides.
2. Physicists: It is common for a person suffering from major depression to have alterations in sleep hygiene, which can lead to insomnia or hypersomnia, as well as alterations in eating, causing weight loss or gain. Motor skills may also be affected, with the presence of slowness of movement and a constant feeling of fatigue and lack of energy.
3. Physicists: It is common for a person suffering from major depression to have alterations in sleep hygiene, which can lead to insomnia or hypersomnia, as well as alterations in eating, causing weight loss or gain. Motor skills may also be affected, with the presence of slowness of movement and a constant feeling of fatigue and lack of energy.
4. Behavioral: a lack of interest appears in activities that previously generated satisfaction, along with a lack of motivation.
5. Intellectual or cognitive: a decrease in the ability to concentrate, make decisions and think in general may appear.
6. Social: the symptoms presented in the depressive disorder can lead to isolation of the person, thereby producing a deterioration in social relationships.

To talk about the causes of depression we must keep in mind the biological, personal and environmental factors. Its origin can be attributed to one or more of these factors.

Biological factors

• Alteration in neurotransmitters: Our brain works from correct communication between the neurons of the brain. Neurons can communicate with each other using neurotransmitters, such as dopamine, serotonin, and norepinephrine. In depression these neuronal connections are altered and therefore poor brain functioning occurs.
• Alterations in brain areas: In depression, an alteration occurs in the frontal area and the limbic system of our brain.
• Genetic alterations: compared to genetic inheritance in depression, where there is a greater chance of developing a depressive disorder if a close relative has suffered one, a genetic factor is seen in said disorder. However, currently a gene that is related to the onset of depression has not yet been identified.

Factors related to personality

Each person’s personality makes us more vulnerable to the possible development of a pathology. In depression, the most insecure, anxious, dependent, perfectionist and self-demanding are more likely to develop depression.

Environmental factors

Certain traumatic or stressful events in the person’s life, such as loss of a family member, bereavement, precarious economic situations, acute illnesses,… can predispose the development of the disease.

The treatment of major depression must be established on an individualized basis, because the disorder can present in very different ways in each person.

Faced with this, we can have different therapeutic alternatives, focusing on the psychological and pharmacological treatment. These two modalities are not mutually exclusive; in fact, the vast majority of remissions of depressive disorder occur due to the benefit of the two interventions in combination.

In depressive disorders, the therapeutic modality that has demonstrated the greatest effectiveness has been cognitive-behavioral therapy. The objective of this therapeutic modality is to produce a change in the emotions that the person feels, in the thoughts that have been established and in the behaviors that they develop because of these thoughts and feelings.

The person who suffers from major depression maintains a negative view of him, the world and the future, with despair. This perception appears due to a set of irrational automatic thoughts that have been established and that produce alterations in their daily life, for example “why should I look for a partner if no one is going to love me?” These thoughts arise spontaneously and naturally, because the person He has internalized them. Cognitive-behavioral psychotherapy aims change thoughts automatically s that maintain the disorder, through healthier, positive and rational constructions, based on the technique of cognitive restructuring. Faced with the possibility of changing this set of thoughts, the person will begin to act differently, to mobilize and thus feel much better.

On the other hand, it will also treat the personality traits that maintain the depressive disorder, to help the person have a lower vulnerability to depressed mood.

In this intervention, learning is important to be able to identify early onset of symptoms and possible relapses.

Finally, taking into account that comorbidity with peaks of anxiety and stress is very common in depression, it will be important to provide the person with Strategies to combat these anxiety symptoms where the therapist will offer you different relaxation techniques or improvement in problem-solving skills to be able to face them.

The main axis of the pharmacological treatment of major depression lies in the drugs called antidepressants. The need for its administration in severe or moderate cases of major depression has been empirically demonstrated.

An important aspect when taking it is that the person must be aware that the effects of pharmacological treatment for depression They start to take effect between 3 or 4 weeks of his administration. On the other hand, it should be noted that we can find a wide variety of antidepressant drugs, which will be prescribed depending on the needs and characteristics of each patient.

For the pharmacological treatment of the disorder, we can use the following medications for major depression:

• Selective serotonin reuptake inhibitors (SSRIs).
• Serotonin and norepinephrine reuptake inhibitors (SNRIs).
• Atypical antidepressants.
• Tricyclic antidepressants.
• Monoamine oxidase inhibitors (MAOIs).

If a loved one has depression, you may be interested in How to Help a Person with Depression.

This article is merely informative, at PsychologyFor we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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