What’s unspecified depressive disorder?

Depression is a broad category with several subtypes, each with distinct symptom patterns. Knowing which type of depression you have can help ensure you get the right support for your needs.

Sometimes, a person won’t meet the criteria for one of the subtypes of depression. But if they’re experiencing significant struggles, they might have unspecified depressive disorder ^[1]. This term is used when someone’s symptoms don’t fit into the other categories of depressive disorders.

Understanding the language

You don’t need to understand all the ins and outs of diagnostic criteria to ask for help. But for some people, exploring clinical language can be helpful. Having words to describe your experiences with depression can be validating and remind you that you’re not alone. 

In the past, unspecified depressive disorder was called depression not otherwise specified ^[2] (NOS). Today, these terms are sometimes used interchangeably along with “subthreshold” depression ^[3], however it’s important to note that subthreshold depression is not an official diagnosis. 

Having unspecified depressive disorder might involve ongoing struggles with mood that impact functioning. But your experiences may not meet the threshold for other depressive disorders, like major depressive disorder (MDD) or persistent depressive disorder (PDD). This might be due to symptom severity, duration, or other factors.

Symptoms of unspecified depressive disorder

To receive a depressive disorder diagnosis, you’ll need an evaluation from a medical or mental health professional. They’ll want to know your medical, social, family, and mental health history. They'll also ask when your symptoms started and what tends to make them better or worse. Then, they’ll compare your experiences with the diagnostic criteria for depressive disorders outlined in the Diagnostic and Statistical Manual of Mental Disorders ^[4] (DSM). 

If you don’t meet the criteria for one of the more common depressive disorders, your provider may assess you for unspecified depressive disorder. To receive this diagnosis, a person must have repeated periods of dysphoria ^[5]. 

Dysphoria can show up in different ways, including:

• Uneasiness

• Irritability

• Restlessness

• Complex and often contradictory feelings

• Inner turmoil 

• Ambivalence 

Along with dysphoria, a person must have at least four other depressive symptoms ^[1] that last for two weeks or more. 

Symptoms include: 

• Feeling sad or depressed most of the day

• Loss of interest in activities you used to enjoy

• Weight fluctuations or appetite changes

• Sleep troubles, like insomnia and sleeping more than usual

• Fatigue or low energy

• Restlessness, fidgeting, or unusually slow movement observed by others

• Feelings of guilt or worthlessness

• Trouble concentrating

• Self-harm or thoughts of death or suicide*

Lastly, with unspecified depressive disorder, a person cannot have previously met criteria for a similar mood disorder. And their depression can't be due to another disorder.

*A note on safety: If you’re having thoughts of harming yourself, don’t hesitate to ask for help. You can contact the National Suicide and Crisis Lifeline by dialing 988 from any phone. Their counselors will provide confidential support and resources to help keep you safe.

Causes and risk factors for unspecified depression

Like other mental health concerns, we aren’t yet entirely sure what causes unspecified depression. 

But researchers have uncovered a few factors that may increase your risk ^[6], including:

• Genetics: If you have a first-degree relative (like a sibling or parent) who has depression, you might be more likely to develop it.

• Biology: Differences in your brain’s structure and signaling may contribute to the onset of depression.

• Environment: Stressful life events like an unexpected loss may lead to depression in people who are predisposed. Once a person has one depressive episode, they’re at a much higher risk of future episodes.

• Medical conditions: Sometimes depression can accompany medical conditions, like: 

  • Thyroid disorders

  • Adrenal gland disorders

  • Some brain tumors, stroke

  • AIDS

  • Parkinson’s disease

  • Multiple sclerosis

How to cope with unspecified depressive disorder

There’s no cure for unspecified depressive disorder. But it can be managed with the right support. 

These supports might make a difference and help you feel more like yourself: 

• Therapy: Therapy can provide a safe space to talk about how depression is impacting your life. It can also help you gain insight into your thoughts, feelings, and behaviors, and learn coping strategies to improve your well-being.

• Medication: If you’re interested in taking medication to manage your depression, you’ll need to speak to a psychiatrist or medical professional. They can talk to you about the pros and cons of various antidepressants and help you make the right choice for your needs.

• Lifestyle changes: Taking care of your body can support your mental health. Eating a balanced diet, getting adequate rest, exercising, and making time for self-care can help you manage depression.

• Alternative treatments: Sometimes, people with mild depression find relief through alternative treatments such as acupuncture, massage, hypnosis, or biofeedback. These can be used alongside therapy, medication, and other treatments. It’s important to find a qualified professional who’s well versed in treating your symptoms.

Clinician’s take

A common misconception is that ‘unspecified’ means less real or less serious. I often reframe this with my clients by validating that the label reflects current diagnostic limits, not the intensity of their suffering. Their distress is real, meaningful, and worthy of care.

Ashley Ayala, LMFT

Clinical reviewer