Minor depressive disorder, also known as minor depression, is a mood disorder that does not meet the full criteria for major depressive disorder but at least two depressive symptoms are present for a long time. These symptoms can be seen in many different psychiatric and mental disorders, which can lead to more specific diagnoses of an individual's condition. However, some of the situations might not fall under specific categories listed in the Diagnostic and Statistical Manual of Mental Disorders. Minor depressive disorder is an example of one of these nonspecific diagnoses, as it is a disorder classified in the DSM-IV-TR under the category Depressive Disorder Not Otherwise Specified (DD-NOS). The classification of NOS depressive disorders is up for debate. Minor depressive disorder as a term was never an officially accepted term, but was listed in Appendix B of the DSM-IV-TR. This is the only version of the DSM that contains the term, as the prior versions and the most recent edition, DSM-5, do not mention it. A person is considered to have minor depressive disorder if they experience two to four depressive symptoms, with one of them being either depressed mood or loss of interest or pleasure, during a two-week period. The person must not have experienced the symptoms for two years and there must not have been one specific event that caused the symptoms to arise. Although not all cases of minor depressive disorder are deemed in need of treatment, some cases are treated similarly to major depressive disorder. This treatment includes cognitive behavioral therapy (CBT), anti-depressant medication, and combination therapy. Research supports the notion that minor depressive disorder is an early stage of major depressive disorder, or that it is simply highly predictive of subsequent major depressive disorder.
Signs and symptoms Minor depressive disorder is very similar to major depressive disorder in the symptoms present. Generally, a person's mood is affected by thoughts and feelings of being sad or down on themself or by a loss of interest in nearly all activities. People can experience ups and downs in their life everyday where an event, action, stress or many other factors can affect their feelings on that day. However, depression occurs when those feelings of sadness persist for longer than a few weeks. A person is considered to have minor depressive disorder if they experience two to four depressive symptoms during a two-week period. The Diagnostic and Statistical Manual of Mental Disorders lists the major depressive symptoms. Depressed mood most of the day and/or loss of interest or pleasure in normal activities must be experienced by the individual to be considered to have minor depressive disorder. Without either of these two symptoms, the disorder is not classified as minor depressive disorder. Other depressive symptoms include significant weight loss or weight gain without trying to diet (an increase/decrease in appetite can provide clues as well), insomnia or hypersomnia, psychomotor agitation or psychomotor retardation, fatigue or loss of energy, and feelings of worthlessness or excessive guilt. All of these signs can compound on each other to create the last major symptom group of minor depressive disorder: thoughts of death, suicidal thoughts, plans to commit suicide, or a suicide attempt. Minor depressive disorder differs from major depressive disorder in the number of symptoms present with five or more symptoms necessary for a diagnosis of major depressive disorder. Both disorders require either depressed mood or loss of interest or pleasure in normal activities to be one of the symptoms and the symptoms need to be present for two weeks or longer. Symptoms also must be present for the majority of the length of a day and present for a majority of the days in the two-week period. Diagnosis can only occur if the symptoms cause "clinically significant distress or impairment". Dysthymia consists of the same depressive symptoms, but its main differentiable feature is its longer-lasting nature as compared to minor depressive disorder. Dysthymia was replaced in the DSM-5 by persistent depressive disorder, which combined dysthymia with chronic major depressive disorder.
Treatment Treatment of minor depressive disorder has not been studied as extensively as major depressive disorder. Although there are often similarities in the treatments used, there are also differences in what may work better for the treatment of minor depressive disorder. Some third-party payers do not pay to cover treatment for minor depressive disorder. The leading treatment techniques for minor depressive disorder are the use of antidepressants and therapy. Typically, patients with minor depression were treated by watchful waiting, prescribed antidepressants, and given brief supportive counseling, but Problem-Solving Treatment for Primary Care (PST-PC) is a Cognitive-Behavioral Therapy that has gained popularity. In one study, PST-PC and Paroxetine, an antidepressant, were shown to be equally effective in significantly reducing symptoms. In another study, PST-PC was compared with the more typical care of the time and shown to reduce symptoms more quickly. Although the use of antidepressants has been widely used, not all agree that it is an appropriate treatment for some minor depression disorder settings. Another alternative that has been researched is the use of St. John's wort (Hypericum perforatum). This herbal treatment has been studied by various groups with various results. Some studies show evidence of the treatment being helpful to treat minor depression, but others show that it does no better than the placebo.
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