According to DSM-5 criteria, a diagnosis of Major Depressive Disorder requires at least five symptoms present during the same two-week period, representing a change from previous functioning. At least one of the five symptoms MUST be:

• A Fatigue or loss of energy
• B Diminished ability to think or concentrate
• C Feelings of worthlessness or excessive guilt
• D Depressed mood or loss of interest or pleasure ✓

Explanation

DSM-5 requires five or more of the nine depressive symptoms for at least two weeks, and the symptom cluster must include either depressed mood or anhedonia (loss of interest or pleasure); without one of these two gateway symptoms, the diagnosis cannot be made regardless of how many other symptoms are present. Fatigue, guilt, and concentration difficulty count toward the total of five but can never substitute for the required cardinal symptom.

Reference: Diagnostic and Statistical Manual of Mental Disorders, 5th ed.

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Written and medically reviewed by the StethoPrep medical team.