Let yourself become Depressed

Schmachtenberger on Depression:

It’s OK to be depressed in a sick/crazy society - but there is still agency.

Depression (and how we accept and overcome it) thus links to catasthrophic-risk.

We can not change everything that we face, but nothing can be changed until it is faced - James Baldwin

The International Classification of Diseases (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are two of the most widely used classification systems for mental health disorders, including major depression. While they have a lot in common, there are some key differences in how they define major depression.


In the ICD-10, Major Depression is classified under “Depressive Episode” (codes F32-F33). The diagnosis requires at least two out of three typical symptoms:

  1. Depressed mood
  2. Loss of interest or pleasure
  3. Reduced energy or increased fatigueability

Additionally, at least two out of seven other symptoms should be present, such as:

  • Reduced concentration and attention
  • Reduced self-esteem and self-confidence
  • Ideas of guilt and unworthiness
  • Bleak and pessimistic views of the future
  • Ideas or acts of self-harm or suicide
  • Disturbed sleep
  • Diminished appetite


In the DSM-5, Major Depressive Disorder (code 296.2x/296.3x) requires at least five symptoms to be present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms should be either:

  1. Depressed mood
  2. Loss of interest or pleasure

Other symptoms include:

  • Significant weight loss or gain, or decrease or increase in appetite
  • Insomnia or hypersomnia
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate, or indecisiveness
  • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

In summary, while both ICD-10 and DSM-5 require the presence of a depressed mood and/or loss of interest or pleasure for the diagnosis of major depression, the number and type of additional symptoms required differ between the two systems.