How is unipolar major depression diagnosed?

Doctors in the United States and many other countries use a manual of diagnostic criteria drawn from a large body of medical research and clinicians’ experience. It is published by the American Psychiatric Association, and it is called the Diagnostic and Statistical Manual of Mental Illness, Fourth Edition. The criteria are written somewhat technically for doctors (see Appendix B). Here is an easy-to-use checklist that can help you determine if you are clinically depressed.

Criteria That Doctors Use to Diagnose Major Unipolar Depression

Check each statement that represents the way you have felt over the last two weeks.

1. Have you had a feeling of sadness nearly every day?
2. Have you lost interest or enjoyment in nearly all your activities?
3. Has your appetite changed OR have you lost more than five pounds without trying to diet?
4. Have you had difficulty going to sleep OR are you waking too early?
5. Have your thoughts or behavior slowed so much that other people notice?
6. Have you had low energy OR been fatigued nearly every day?
7. Have you had feelings of worthlessness OR guilt?
8. Have you had difficulty thinking OR concentrating OR making decisions?
9. Have you been thinking of death or suicide, OR have you planned or tried suicide?

Here’s How to Score

Step 1. If you did not check either Question 1 or 2 above, stop you probably do not have unipolar major depression.

Step 2. If you checked five or more of Questions 1-9, go to Step 3. Step 3. If the sum of all these problems is severe enough to interfere with your work, school, family relationships, or social activities, you meet the official criteria for unipolar major depression. Go to a doctor who can evaluate you to determine if you really do have the disorder.