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The Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (American Psychiatric Association, 1994) is the current reference used by mental health professionals and physicians to diagnose mental disorders. This publication is often referred to as the DSM or DSM-IV, and we use such abbreviations here for convenience. The American Psychiatric Association began publishing the DSM in 1952, and it has since gone through several revisions before the most recent version, the fourth edition, was published in 1994. The current DSM-IV lists over 200 mental health conditions and the criteria required for each one in making an appropriate diagnosis. Diagnostic criteria for mental disorders are essentially descriptions of symptoms that fall into one of four categories. In major depressive disorder for example, affective or mood symptoms include depressed mood and feelings of worthlessness or guilt. Behavioral symptoms include social withdrawal and agitation. Cognitive symptoms, or problems in thinking include difficulty with concentration or making decisions. Finally, somatic or physical symptoms include insomnia or hypersomnia (sleeping too much). The clinical usefulness of the DSM-IV is much more than a tool for making diagnoses. It is used by mental health professionals and physicians as a guide for communicating about mental health conditions. When two clinicians discuss a diagnosis such as "major depressive disorder, single episode, severe with psychotic features," they both have the same conceptualization of various aspects of the illness. Without the DSM-IV, the two clinicians might have very different perceptions of the condition. The DSM-IV also allows mental health professionals to reach consensus on which symptoms or groups of symptoms should define which disorders. Such decisions are based on empirical evidence (research results), usually by a multidisciplinary staff of professionals. Further, the DSM-IV is used as an educational tool and a reference for conducting all types of research (e.g., clinical trials, prevalence studies, outcome research). The DSM-IV is not used to categorize people, but to categorize conditions or disorders that people have. This may be a subtle distinction, but it is a very important one. We do not say that a person is cancer, or is heart disease, or is an illness. A person has an illness. Likewise, we should not say that a person is a depressive, but that a person has clinical depression. Along the same lines, the value of diagnostic labels is often debated among mental health professionals and the general public. On the negative side, some people believe that making a diagnosis is simply the act of labeling a person. Once a person is labeled he or she may have difficulty overcoming the label, may lose hope of recovery, or may come to believe that he or she is the label. On the positive side, some people are relieved when they finally learn that the symptoms they are experiencing have a name. This often offers a sense of hope and personal control over the illness as more can be learned about its treatment, causes, and outcome.
The depressive disorders that are described on this web site are grouped under a category in the DSM-IV called Mood Disorders. Included in this category are major depressive disorder, dysthymic disorder, bipolar disorder, cyclothymic disorder, mood disorder due to a general medical condition, and substance-induced mood disorder. Two subtypes of mood disorders include seasonal affective disorder and postpartum depression, while premenstrual dysphoric disorder has been proposed as a diagnosis for further study. For each of these mood disorders there are specific criteria that a person's symptoms must meet in order to receive a diagnosis. Once a diagnosis of a particular mood disorder is made, more detailed information about the diagnosis can be provided in the form of "specifiers. For instance, take a look at the following two diagnoses:
Specifiers associated with the mood disorders are listed below:
 
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