61. Case Study

Aliya is currently pregnant with her second child at 25 weeks gestation Her first child is 20 months old. She is coming to you to help her decide if what she is experiencing is normal for pregnancy or if she is having symptoms of a perinatal mood disorder. During her interview, she describes poor sleep, increased tearfulness, low energy, and irritability. She states that her first child sleeps well and is not interrupting her sleep, and that she is not waking up due to increased urination or physical discomforts of pregnancy. She reports that she has not ever been as tearful as she is now, including during her previous postpartum period She states that she has been tested by her obstetrician (OB) care provider for anemia and thyroid dysfunction and her lab results were normal. She is noticing that her irritability is affecting her relationship with her partner She worries that she is "pushing him away:" even though he is trying to be supportive.

Question: In the scenario. Aliya is describing increased tearfulness. Her symptoms occur daily for the last two weeks and are affecting her functioning. In addition to depressed mood, what other symptom would she need in order to meet the criteria of DSM-5 diagnosis of Major Depressive Disorder, with peripartum onset?