A 30-year-old woman reports 2 years of persistently depressed mood, accompanied by loss of pleasure in all activities, ruminations that she would be better off dead, feelings of guilt about bad things she has done, and thoughts about quitting work because of her inability to make decisions. Although she has never been treated for depression, she feels so distressed at times that she wonders if she should be hospitalized. She experiences an increased need for sleep but still feels fatigued during the day. Her overeating has led to a 24 lb. weight gain. She denies drug or alcohol use, and her medical workup is completely normal, including laboratory tests for vitamins. The consultation was prompted by her worsened mood for the past several weeks. What is the most appropriate diagnosis?
Select one:
a. Bipolar II disorder
b. Major depressive disorder with melancholic features
c. Major depressive disorder
d. Persistent depressive disorder (dysthymia) with persistent major depressive episode e. Cyclothymia