Other Specified Depressive Disorder

Symptoms of other specified depressive disorder can vary significantly, but they often include a combination of behavioral, psychological, and physical symptoms. 

Psychological symptoms

Below are some of the potential ways in which other specified depressive disorder may impact an individual psychologically, per the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition:

• Low, depressed mood or sadness
• Thoughts of guilt, worthlessness, hopelessness, or helplessness
• A sense of apathy or numbness 
• Low self-worth or self-blame
• Suicidal ideation

Behavioral symptoms

Below are some ways in which a depressive episode may impact behavior, all of which have the potential to cause significant distress:

• Irritability, frequent frustration, or sudden outbursts of anger
• Little interest in activities that were previously enjoyed, such as sports, sex, or hobbies
• Slowed thinking or movement, significant enough for others to notice
• Difficulty concentrating or making decisions
• Difficulty meeting responsibilities at work, in school, or within relationships
• Reduced social connection, such as becoming withdrawn or detached 
• A pessimistic outlook
• Impulsivity
• An increased use of alcohol or other substances 
• Self-harm

Physical symptoms

Physical symptoms of depression may include the following: 

• Weight and appetite fluctuations
• Restlessness 
• Low sex drive
• Sleeping changes, including difficulty sleeping or sleeping excessively
• Unexplained chronic pain, such as headaches, cramps, or back pain
• Fatigue and lethargy 
• Muscle and joint aching

Diagnosis 

The types, number, frequency, severity, and duration of symptoms experienced as a result of depressive disorders can impact diagnosis. For example, to receive a diagnosis of major depressive disorder, five or more symptoms listed in the DSM must be present on most days within the past two weeks, including low mood or loss of interest in activities that were once enjoyed.

For persistent depressive disorder, on the other hand, two or more symptoms must be present for at least two years without remission. A diagnosis of other specified depressive disorder often includes several diagnostic criteria for another depressive disorder, but not all.

The theory that serotonin imbalance causes major depressive disorder and related conditions is widely believed. However, there is no substantial evidence to support this theory. Instead, many complex, interacting factors could contribute to depression, including biological differences, genetics, and environmental factors. Some of these risk factors and potential causes are summarized below:

• Biological differences. Brain differences, such as a smaller hippocampus, may be correlated with depressive disorders in some cases. 
• Chronic stress. People with depressive disorders often experience chronic stress in some areas of daily life.  
• Genetics. It’s estimated that major depressive disorder is hereditary by 40% to 50%. Individuals with a biological sibling or parent with a depressive disorder may be at a two to three times higher risk of depression than someone without a strong family history. 
• Gender. As of 2023, 36.7% of women in the US report having been diagnosed with depression at some point in their lives, while only 20.4% of men say the same. However, this statistic may be impacted by symptom differences, societal factors, and stigma that may lead men to be underdiagnosed.  
• Physical health and medical conditions. Conditions such as cancer, hyperthyroidism, multiple sclerosis, and chronic pain can increase depression risk. 
• Sleep. Poor sleep quality can impair emotional regulation and contribute to the development or worsening of depression symptoms. 
• Nutrition quality. Eating patterns may impact depression risk. For example, consuming plenty of fruits, vegetables, and whole grains may be associated with a reduced risk of depression. In contrast, consuming lots of processed animal products, added sugars, and refined grains may be associated with an increased risk of depression. 
• Alcohol, medication, or substance use. Depression and substance use can exacerbate each other. If you have a substance use disorder, you may be at a higher risk of depression.  
• Trauma. Exposure to trauma in childhood can increase the risk of depression later in life. 
• Though these factors are associated with a higher risk of depression, anyone may experience a depressive disorder, whether they exhibit any or none of the above.

Per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, there are many treatment options for depression that may help reduce symptom severity and address distressing thoughts, feelings, and behaviors. The most effective treatment option varies depending on the individual, but many people improve with a combination of talk therapy, medication, and self-care.

Medication

Medication may be recommended in conjunction with therapy in some cases to help manage symptoms. Below are some options you might discuss with your doctor: 

• Selective serotonin reuptake inhibitors (SSRIs). SSRIs work by blocking the reuptake of serotonin, a hormone associated with mood, by nerve cells, which increases serotonin levels in the brain. It’s the most commonly prescribed class of antidepressants, and though they can cause some side effects, SSRIs are often well-tolerated and effective. 
• Serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs block serotonin and norepinephrine reuptake to improve alertness and focus. Like SSRIs, SNRIs can cause side effects, but they may effectively reduce symptoms.  
• Tricyclic antidepressants (TCAs). TCAs are considered first-generation antidepressants, as they’ve been prescribed for the treatment of depression longer than any other medication. (SSRIs and SNRIs are examples of second-generation antidepressants.) They may be prescribed if your symptoms have not improved with other antidepressant medications, but they may cause more severe side effects. 
• A combination of medications. In some cases, a combination of antidepressants or other medications may be prescribed to treat your symptoms, particularly if you have coexisting psychiatric disorders. 

While some people with moderate to severe depression can benefit from medication, it can take a while to find the proper type and dosage. It may take several weeks to months for noticeable symptom improvement and for side effects to subside.

Other treatment options

Other treatment options for depression can include the following: 

• Hospital or outpatient care. For some people with more severe cases of depression, hospital or outpatient treatment may be helpful in stabilizing symptoms.
• Repetitive transcranial magnetic stimulation (rTMS). This treatment is a non-invasive option for treatment-resistant depression that does not require anesthesia and does not hurt. It involves repeated sessions of magnetic frequencies targeting the brain. 
• Electroconvulsive therapy (ECT). When people with severe depression cannot take antidepressant medications or do not improve with antidepressants, ECT may be recommended. This treatment option involves electrically stimulating the brain while under anesthesia, and it’s been suggested to significantly improve symptoms in around 80% of clients with severe major depression. 
• Support groups. Support groups can provide helpful advice for symptom management, improve an individual’s ability to cope with stressors, and reduce isolation. Studies suggest that support groups can be effectively combined with other treatment options to relieve symptoms. 

Self-care

Self-care in combination with a broader treatment plan can be an effective way to cope with symptoms and improve overall mental health. Below are some examples: 

• Lifestyle. Getting enough sleep, engaging in routine, moderate exercise, eating nutrient-dense foods as often as possible, and socializing regularly may significantly improve symptoms. 
• Journaling. Symptom journaling may help you express, track, and process your symptoms, which could improve self-awareness and well-being.
• Meditation. Activities that center body awareness and non-judgmental presence of mind—such as meditation, mindfulness, yoga, or tai chi—may reduce depressive symptoms and improve one’s ability to manage stress and anxiety.

The first-line approach recommended for people with depressive disorders is often cognitive behavioral therapy (CBT). While this type of therapy can be effective, it may not be easily available for individuals balancing busy schedules or experiencing symptoms that make it challenging to leave the house. 

Online CBT, which is provided by many therapists through platforms like BetterHelp, enables clients to attend therapy sessions from the comfort of home. Research suggests that online CBT may effectively address both depression and anxiety, though in-person care may be recommended in cases of severe depression. 

There are a wide variety of additional resources available to help individuals manage or address depressive symptoms, including the following: 

• ADAA Online Support Group. The Anxiety and Depression Association of America (ADAA) provides free online support communities for anxiety and depression (in English and Spanish), post-traumatic stress disorder (PTSD), and major depressive disorder. 
• 988 Suicide and Crisis Lifeline. This lifeline provides 24/7, free support and resources for individuals or loved ones experiencing distress. You can take advantage of these services via their website, by texting 988, or by calling 800-985-5990. There are also specialized resources available for Spanish speakers, American Sign Language users, and veterans.
• The Centers for Disease Control and Prevention. The CDC lists additional community resources and links to help people learn more about depression. 

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

Please see our Get Help Now page for more immediate resources.

A 2022 study suggests that there was no difference in two-year quality of life between individuals with a depressive disorder who were taking antidepressants and individuals with a depressive disorder who were not taking antidepressants. However, this study’s findings are complicated by several factors. For example, individuals taking medications are likely to have more severe depression than individuals who are not taking medications, as antidepressants may not be commonly prescribed for cases of mild depression. This factor and others may limit the significance of these findings. 

That said, since the introduction of SSRIs in the 1980s and SNRIs in the 1990s, scientists have been investigating new medications that may be quicker to take effect, safer for pregnancy, and present fewer side effects. There are several pharmaceuticals currently being researched that may be more beneficial than current antidepressants, including those that act on glutamate receptor (GluRs) ligands. GluR medications may reduce excessive excitation and improve brain function, resulting in a reduction of depressive symptoms. Additionally, a 2022 study explored the potential for orexin receptor agonists to reduce anxiety and improve sleep, motivation, and concentration, which are often impaired with depression. Research in these areas is ongoing.

Below are several statistics on other specified depressive disorder:

• Across the globe, around 5% of adults are estimated to experience depressive disorders, though the prevalence of other specified depressive disorders in particular is unclear. 
• According to the Anxiety and Depression Association of America, around 60% of people with major depressive disorder seek treatment. 
• A 2019 survey conducted by the National Center for Health Statistics found that 10.8% of adults aged 18 and over had symptoms of anxiety or depressive disorders.
• Cognitive behavioral therapy is the most effective form of psychotherapy for depression, with 42% of people experiencing significant symptom improvement after this treatment and 36% experiencing total remission.