Depressive Disorder

Not Otherwise Specified

Someone who self-reports feeling depressed, has suicidal impulses, has lost pleasure in life, and is not sleeping well, is seriously depressed, but because he does not have four of the secondary criteria cannot be diagnosed as having "major" depression. The same goes for someone who appears to suffer all the symptoms of dysthymia, but for a period which has not lasted two years. Such people are usually classified with the diagnosis of Depressive Disorder Not Otherwise Specified (or DDNOS for short), a catchall term that may include some people who are quite seriously depressed and others who aren't.

This grouping is used for all patients who show some symptoms of depression but do not meet the criteria for one of the more restrictive diagnoses. Their symptoms may be less severe, or of shorter duration, or they may meet most of the criteria, but not all, for major depression or dysthymia. This category also includes women suffering from depression associated with the menstrual cycle and people with schizophrenia or other psychotic disorder with an associated depression. But it still includes people who are grieving, who are depressed as a result of a loss or change in their lives, who are dealing with a medical problem and depressed as a result. In other words, the diagnosis includes a wide variety of people who suffer from depression that has no clear external cause, but is serious enough to interfere with their ability to function.

Estimates are that, at any given time, 11 percent of the population meets the criteria for DDNOS. This is truly an astounding number, making DDNOS easily the single most common disease in the United States. The combined incidence of major depression, dysthymia, and DDNOS approaches 20 percent at any given time. This does not mean that 20 percent of the population will have depression at some time in their lives, but that 20 percent have it now. That means one in five of your friends, family members, and coworkers have it.

On the next page we will examine Bipolar Disorder.