A. Five (or more) of the following symptoms have been present during the same two-week period and represent a change from previous functioning; at least one of the symptoms is (1) depressed mood or (2) loss of interest or pleasure
	(1) Depressed mood most of the day, nearly every day, as indicated by subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful)
	(2) Markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day (as indicated by subjective account or observation made by others)
	(3) Significant weight loss when not dieting, or weight gain (e.g., a change of more than 5 percent of body weight in one month), or decrease or increase in appetite nearly every day
	(4) Insomnia or hypersomnia nearly every day
	(5) Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feeling of restlessness or being slowed down)
	(6) Fatigue or loss of energy nearly every day
	(7) Feeling of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
	(8) Diminished ability to think or concentrate, or indecisiveness, nearly every day (by subjective account or as observed by others)
	(9) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
B. Symptoms do not meet the criteria for mixed bipolar disorder
C. Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
D. Symptoms are not caused by the direct physiologic effects of a substance (e.g., drug of abuse, medication) or a general medical condition (e.g., hypothyroidism)
E. Symptoms are not caused by bereavement (i.e., after the loss of a loved one, the symptoms persist for longer than two months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation)