Depression Symptoms (Major Depressive Disorder)

By Steve Bressert, Ph.D.

~ 3 min read

The symptoms of depression — technically referred to as major depressive disorder — are

characterized by an overwhelming feeling of sadness, isolation, and despair that lasts two
weeks or longer at a time. Depression isn’t just an occasional feeling of being sad or lonely,
like most people experience from time to time. Instead, a person feels like they’ve sunk into
a deep, dark hole with no way out — and no hope for things ever changing.
Symptoms of Clinical Depression
A person who suffers from a major depressive disorder (sometimes also referred to
as clinical depression or simply depression) must either have a depressed mood or a loss of
interest or pleasure in daily activities consistently for at least a 2 week period. This depressed
mood must represent a significant change from the person’s normal mood.
Social, occupational, educational, or other important functioning must also be negatively
impacted by the change in mood. For instance, when a person who’s depressed starts
missing work or school, or has stopped going to classes or their usual social engagements
(such as hanging out with friends).

Related: Types of Depression

Clinical depression is characterized by the presence of 5 or more of these depressive
symptoms:

 Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g.,
feeling sad, blue, “down in the dumps,” or empty) or observations made by others (e.g., appears
tearful or about to cry). (In children and adolescents, this may present as an irritable or cranky, rather
than sad, mood.)
 Markedly diminished interest or pleasure in all, or almost all, activities every day, such as no interest
in hobbies, sports, or other things the person used to enjoy doing
 Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 percent of
body weight in a month), or decrease or increase in appetite nearly every day
 Insomnia (inability to get to sleep or difficulty staying asleep) or hypersomnia (sleeping too much)
nearly every day
 More days than not, problems with sitting still, including constant restlessness, pacing, or picking at
one’s cloths (called psychomtotor agitation by professionals); or the opposite, a slowing of one’s
movements, talking very quietly with slowed speech (called psychomotor retardation by
professionals)
 Fatigue, tiredness, or loss of energy nearly every day — even the smallest tasks, like dressing or
washing, seem difficult to do and take longer than usual
 Feelings of worthlessness or excessive or inappropriate guilt nearly every day (e.g., ruminating over
minor past failings)
 Diminished ability to think or concentrate, or indecisiveness, nearly every day (e.g., appears easily
distracted, complains of memory difficulties)
 Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideas without a specific plan,
or a suicide attempt or a specific plan for committing suicide
A depressed mood caused by substances (such as drugs, alcohol, medications) is not
considered a major depressive disorder, nor is one which is caused by a general medical
condition. Major depressive disorder generally cannot be diagnosed if a person has a
history of manic, hypomanic, or mixed episodes (e.g., a bipolar disorder) or if the depressed
mood is better accounted for by schizoaffective disorder and is not superimposed on
schizophrenia, a delusion or psychotic disorder.

Depression is also experienced as a loss of interest and energy in things the person
normally enjoys doing, things like working, going out, or being with family and friends. Most
people with this condition also experience problems with eating and sleeping — either too
much or too little. A depressed person’s memory and ability to concentrate will often be
impaired, too; they may also be more irritable or feel restless all the time.

Related: Teen Depression Symptoms

Depression & Grief
In keeping with updates to the major depressive disorder criteria in DSM-5 (the latest
diagnostic manual of mental disorders), a person can suffer from a major depressive
episode during a period of bereavement or grief, such as after the loss of a loved one. This is
a significant change from the previous DSM-IV criteria, which did not give the diagnosis of
major depression if the person was grieving over a significant loss in their lives. This change
was made with the rationale that since bereavement may induce great suffering in a person,
it may induce an episode of major depressive disorder.
In other words, it is not normal for the symptoms of bereavement to induce marked
functional impairment, morbid preoccupation with worthlessness, suicidal ideation,
psychotic symptoms, or psychomotor retardation for two months or more. Thus, when they
do occur together, the depressive symptoms and functional impairment tend to be more
severe and the prognosis is worse compared with bereavement that is not accompanied by
major depressive disorder. Bereavement-related depression tends to occur in persons with
other vulnerabilities to depressive disorders, and recovery may be facilitated by
antidepressant treatment.