We claimed in chapter 1 that a flawed definition may be facilitating the recent surge in reported depressive disorder and may even lie at its very heart. To justify our claim, we now turn to a detailed examination of the DSM criteria for depressive and related disorders. Although the history of depression presented in the preceding chapter logically takes us up to the DSM-III, in order to ensure that our discussion applies to current diagnostic practices, we address the criteria presented in the latest edition—the fourth, text-revised edition DSM-IV-TR (2000). This does not represent much of a conceptual leap because the current criteria are almost identical to those in the DSM-III.
We start by placing the DSM criteria for Major Depressive Disorder (MDD) in the context of the DSM+U0027s approach to affective disorders, also known as mood disorders, the larger category under which depressive disorders fall. The following distinctions are useful to keep in mind:
MDD is [unipolar] depression, which means that the individual has only depressive symptoms rather than oscillating back and forth between depressive and manic symptoms such as elevated mood and grandiosity. Mood disorders that include manic episodes are known as Bipolar Disorders (formerly manicdepressive disorders), which are relatively rare compared with the claimed rates of unipolar depressive disorder. Bipolar I Disorder is often quite severe; milder forms include Bipolar II Disorder and Cyclothymic Personality Disorder. None of these forms of bipolar disorder is the focus here.