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Typically, for a person to be diagnosed with a seasonal pattern, they must have more seasonal episodes than nonseasonal episodes during their lifetime.This disorder can occur as mild, moderate or severe in individuals depending on the level of problems that the person has doing their daily activities (work, school, etc.).For example, the person's mood brightens when good things happen, when they gain weight or have an increase in appetite, sleep more than usual, or have heavy almost paralyzing feeling in their arms and legs.These features should not occur in the same episode with melancholic or catatonic features.

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If at least three of these manic/hypomanic symptoms are present nearly every day during the most of the days that the person has a major depressive episode, then the person is said to have mixed features along with MDD.For example, a differential diagnosis of MDD with attention-deficit/hyperactivity disorder narrows down the diagnosis to describe that a person is highly distractible and irritable during a depressive episode rather than just being sad.Clinicians may use the following differential diagnoses to describe the current or most recent Major Depressive Disorder: Clinicians can also label the episode as occurring with: Anxious Distress - this is when a person feels keyed up/tense, is unusually restless, or has a feeling or fear that something awful may happen or they may lose control.Psychotic Features - this is used when delusions and/or hallucinations are experienced.When the delusions and/or hallucinations are consistent with typical depressive feelings such as personal weakness, guilt, disease, or deserved punishment, they are said to be mood-congruent.

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